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Thread: Pain! Thrush? So overwhelmed and confused.

  1. #1
    Join Date
    Apr 2013
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    Salt Lake City
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    Default Pain! Thrush? So overwhelmed and confused.

    You are all probably getting really tired of hearing about my pain. I've been battling nipple pain for over two months (my twins are almost 4 months old). The pain is worse with pumping and I've tried 5 different pumps. Currently I'm using the Medela Pump in Style. There is pain when feeding, too, so it isn't just a pump issue. I have had four rounds of antibiotics including the one given to me during delivery and one round that I just completed for a root canal. The pain feels like an electric shock, though sometimes my nipples are itchy and I get some shooting breast pains. The nipple often turns white after a feeding and at other random times. My nipples are bright pink and they look cracked and blistery.

    I'm on my 4th thrush treatment. The babies were only treated the first time (they never had symptoms). They had oral diflucan while I used topical Nystatin. I saw no improvement over the course of 3 weeks. Then I got one pill of diflucan and saw no improvement. Then I tried the Nystatin again, leaving it on for longer periods, but saw no improvement. I'm now on day five of a seven-day diflucan prescription and am not yet seeing improvements.

    I saw a lactation consultant (not IBCLC, I've had a hard time finding one!) and she suggested B6 for Reynauds and the week of diflucan. I've been taking the B6 for a week and haven't seen any improvement. I asked repeatedly, and she said I do not have to treat the babies again because they have no symptoms and that there are two different kinds of thrush. She said to take the diflucan every other day because it stays in your system. My doctor was SHOCKED by my request for the week of diflucan and had me go in to check for signs of an infection. She said my nipples looked irriated, but nothing else looked wrong. She gave me the diflucan and confirmed that I did not need to treat the babies again, but said to not take it every other day. I followed her advice, and am taking it daily. When I got the one day of diflucan, I asked my pediatrician and he said we didn't need to treat the babies again, either.

    But everything I've read here, on Dr. Sears, on Kellymom, etc etc etc says that you have to treat both mom and baby at the same time. You have to treat for two weeks after the symptoms go away. You have to do all of these intense things that leave me overwhelmed like replace bottle nipples every week, wash things in vinegar, leave things in the sun, take specific blends of probiotics, and on and on. You can't use paper breast pads, but also don't use cloth ones because they harbor yeast. It's so much information and I feel like I need to do spells, too, just in case.

    SO, here are my questions:

    1. Do you think it's not thrush at all?

    2. Are there two kinds of yeast, and for one the baby doesn't have to be treated?

    3. Should I be seeing an improvement in my symptoms five days into a diflucan treatment?

    4. Do I need to take 3 weeks or longer of diflucan, and if so, how does one even get that if none of your doctors believe that you need it at all?

    5. How do I find an IBCLC? The search function on this website doesn't work for my state.

    6. What is really necessary from the lists to treat possible thrush effectively?

    Any other information? I've begun to resign myself to two more years of pain...

  2. #2
    Join Date
    Nov 2012
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    Ontario
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    Default Re: Pain! Thrush? So overwhelmed and confused.

    Oh mama, it sounds like you're having a really rough time. Especially when you think you know what's wrong and nobody who is in a position to help you seems to believe it! I'll do my best to answer some of your questions:

    1) It sounds to me like it could indeed be thrush - the fact that you had a non painful period prior to this starting is a good clue, plus the several rounds of antibiotics. It also sounds to me like you're dealing with some painful vasospasms secondary to the thrush. I had the same thing - I'll tell you what eventually worked for me when I had the same thing going:
    -Grapefruit seed extract. Dilute it in water and apply to your nipples several times/day with a cotton swab. If they get too dry, you can use a little vit. E oil (wipe it off before nursing/or make sure it's fully absorbed) before you nurse the babies. You can also swab the babies mouths before they nurse, several times/day. You're right, you both need to be treated even if the babies are aymptomatic. There's some debate about whether nystatin is even worth using - there's usually sugar in the preparation, which can just feed the yeast.
    -plain, over the counter canesten cream. I used it a couple times/day, alternating with coconut oil, which felt really soothing.
    -use the microwave steam bags for your pump parts/nipples. The dishwasher/boiling isn't enough - I reinfected myself with my pump parts this way. The yeast can be really resistant, but the steaming seems to do the trick.
    -use vinegar in the wash, and use hot water where possible. Wear bras/pjs only once before washing, same for towels. I stopped using breast pads. Go braless whenever possible at home
    -treat the vasospasms with heat - a heating pad when you feel it coming on helps, or you can fill a sock with rice and heat that up. I found that a calcium/magnesium supplement as well as the vitamin b supplement (not just b6), as well as fitting in some cardio exercise a few times/week (seemed to improve blood flow).
    -I ended up taking a two week course of diflucan -I think it was 150mg every day, and that's what it took to get rid of it. If I remember correctly, I started noticing it getting slightly better around the 5th day. You need to take it every day, not just every other day! Dr. Newman's thrush protocol has the dosage there, if you need to print it out and show your doc.
    -Take a quality probiotic 3x/day and give it to your babies. You can order special baby ones (I used HMF natogen), or you can just bust open a capsule, wet a finger and sprinkle the powder on, and give it to them to suck off.

    2. I'm sure that in the oodles of reading I did about thrush that I came across something about resistant yeast requiring something other than diflucan. But I'm sorry, I don't have any reference for it now :/
    3. Like I said above, I started seeing an improvement around that time. I think it was day 4 or 5, I honestly can't remember now!
    4. I know you can get diflucan single pills over the counter, but that would get pretty expensive if you don't have a script for it.
    5. Maybe a local LLL leader can direct you to an IBCLC? Or a local health unit?
    6. See my answer to #1. I'm not sure what it'll take to get rid of your thrush - I remember feeling really desperate to get rid of the pain. The vasospasms took longer to go away after the pain of the thrush was gone, but they did eventually subside. I'm really giving you a lot of kudos for nursing TWINS through thrush - it was hard to nurse one baby, nevermind two. I hope you find something that works for you soon

  3. #3
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    May 2006
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    21,343

    Default Re: Pain! Thrush? So overwhelmed and confused.

    Has anyone suggested Nifedipine for the Raynaud's? That's what Kellymom says is used in treatment. See http://kellymom.com/bf/concerns/moth...ple-blanching/

    ETA: has anyone ever suggested doing a culture of your nipples and/or milk? Sometimes drug-resistant bacterial infection can cause symptoms which appear similar to thrush.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4
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    Oct 2012
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    Default Re: Pain! Thrush? So overwhelmed and confused.

    There is such a thing as diflucan-resistant yeast, but it doesn't make sense to me that the twins would not have the same strain. I mean the idea is that it just goes back and forth between babies' mouths and your breasts. Presumably it could be cultured the same way bacteria would be, and sensitivities tested in a micro lab.

  5. #5
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    Apr 2013
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    Default Re: Pain! Thrush? So overwhelmed and confused.

    Thank you so much, everyone. I swear today I'm seeing improvement, but I'm scared it's all in my mind. I started using Gentian Violet and gave the babies a probiotic last night, plus added a pretty fancy looking probiotic to my routine. I'm worried that this much diflucan still won't be enough, you say I can get it over the counter somehow? I could try pestering my doctor some more. I will definitely add grapefruit seed extract to the mix and I've already been obsessively steaming pump parts, bottles, nipples, everything in sight. Yes, I definitely think I'm having the vasospasms, too. Sometimes my nipples are shockingly white.

    I have to believe that if we lived in a more breastfeeding friendly society, this never would have happened. My OBGYN and family doctor said NOTHING about thrush or probiotics or yeast when they prescribed the antibiotics!

  6. #6
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    Nov 2012
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    Default Re: Pain! Thrush? So overwhelmed and confused.

    I was really angry, too, about the lack of knowledge of the health care professionals that I saw. I mentioned thrush to my OB at my 6 week PP appointment, he glanced at my nipples and said 'no, they're fine. Besides, no doctor will look at your breasts while you're nursing because they're always changing'. My family doctor said it wasn't thrush (though he did eventually prescribe the diflucan when I pushed). Two separate dentists said it wasn't thrush cause there were no white patches in her mouth. The first person to diagnose it was a lactation consultant at a breastfeeding clinic at my local health unit. She got me in to see the nurse practitioner there, who ordered some topical cream that helped a bit. But the doctor that she worked with wasn't comfortable ordering oral diflucan, so I ended up having to go back to my family doc for it.

    I don't mean to jack your post, just wanted to share my and at people who don't know what they're talking about, and don't seem to realize the subsequent damage they do.

  7. #7
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    Oct 2012
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    Default Re: Pain! Thrush? So overwhelmed and confused.

    Canestan that carm3 mentioned goes by Lotrimin in the U.S.

    Yeah, it's frustrating. I feel like the OB's don't REALLY feel like breastfeeding is part of their job, and family doctors have such a wide scope of practice they may not deal with that many nursing mothers.

  8. #8
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    Default Re: Pain! Thrush? So overwhelmed and confused.

    Often the best person to see for thrush issues is your child's pediatrician. They at least should be passingly familiar with thrush!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  9. #9

    Default Re: Pain! Thrush? So overwhelmed and confused.

    If you keep treating the thrush and see NO improvement, then it may not be thrush at all.

    It might be worth getting a second (third?) opinion from an IBCLC. You can look for one near you in the ILCA directory: http://www.ilca.org/i4a/pages/index.cfm?pageid=3901

    Or is that the search that wasn't working for you?
    Karen
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  10. #10
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    Default Re: Pain! Thrush? So overwhelmed and confused.

    Quote Originally Posted by @llli*mommal View Post
    Often the best person to see for thrush issues is your child's pediatrician. They at least should be passingly familiar with thrush!
    Unfortunately, he has been one of the least helpful, even though he was so supportive of the breastfeeding when the babies were slow to gain weight. My OBGYN doesn't want to address breastfeeding at all. And my general practitioner seems completely in the dark. I've requested an additional week of diflucan from her today, though. I name-dropped LLL, haha! So hopefully she'll trust that this is a normal protocol.

    Quote Originally Posted by @llli*LLLKaren View Post
    If you keep treating the thrush and see NO improvement, then it may not be thrush at all.

    It might be worth getting a second (third?) opinion from an IBCLC. You can look for one near you in the ILCA directory: http://www.ilca.org/i4a/pages/index.cfm?pageid=3901

    Or is that the search that wasn't working for you?
    I'm definitely still worried that it could be something else. Pumping is STILL very painful today even though it seems as though the pain has decreased overall. Thank you for that page! It works! If I'm not feeling better next week, I will see an IBCLC.

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