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Thread: Thrush - about to give up

  1. #1
    Join Date
    May 2017
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    Default Thrush - about to give up

    I would love some advice if anyone can offer it, as I'm truly at my wit's end. Apologies in advance for the length of this post. My baby and I have had thrush since he was 2 weeks old, likely because of the antibiotics I had to have during labor for GBS. He's now two months old, and after trying just about everything, we're not in any better shape than when we started and his pediatrician seems largely indifferent. The thrush is only on his tongue, and doesn't seem to bother him or cause any symptoms other than the clicking noise he makes when nursing. He's a chubby, healthy baby, which I gather is why the pediatrician can't be bothered to prescribe anything that actually works.

    What we've done for the baby:

    • He was initially prescribed Nystatin, which we used for about 4 weeks and saw no improvement whatsoever.
    • I tried swabbing his mouth with diluted GSE, but that must've burned him because on the second day or so he actually was in too much pain to latch on to the breast or even take a bottle, so had to be fed with a medicine dropper until he felt better. I used diluted GSE on my breasts at the same time, and it seemed to burn me or dry things out and make the pain worse - I have sensitive skin so this wasn't a surprise.
    • I've had him sucking probiotic powder off my finger twice a day.
    • I've swabbed his mouth with a baking soda rinse after each feeding, and then applied lemon juice. Doing this for a week also resulted in no improvement.
    • We tried a three-day course of 1 part 1% gentian violet, 1 part water, which I applied to my nipples and then let him nurse. After seeing no improvement after the 3 days and the thrush actually appearing to get worse, discontinued treatment.
    • He doesn't use a pacifier and infrequently uses a bottle, but everything that goes in his mouth is being sterilized by being either boiled for 10 minutes minimum or (in the case of clothing/burp cloths/etc.) washed on a hot cycle with GSE included in the wash.


    After seeing no results with Nystatin, I requested Diflucan for the baby, and the pediatrician refused, saying he's too young, she's concerned about side effects, and the thrush is not bothering him anyway so we should just wait until it goes away on its own. (How that would ever happen is a mystery since we will keep reinfecting each other ad infinitum.)

    I sought a second opinion from a different pediatrician and she similarly said it was no big deal and wouldn't prescribe anything, but did suggest trying GV again since it might not have worked the first time due to being so diluted (first with water, then breastmilk during feeding). So at her instruction, for the last two days I've applied the undiluted 1% GV directly to his tongue. I looked in his mouth this morning and once again, there's no improvement and it might even be worse. I'll give it another few days but I've just about reached the end of my rope here.

    As for treating me, my obstetrician takes thrush more seriously so prescribed me Diflucan right off the bat (400 mg loading dose, 200 mg daily afterward) and wrote me a prescription for APNO. I also apply coconut oil to my nipples before every feeding, since it lessens any pain and also has antifungal properties. These measures have certainly helped and mostly keep the pain at bay, but every time I have a few days where things feel totally normal and I have no symptoms, the itching/burning/tingling comes right back, obviously, since the baby is just going to keep reinfecting me because his thrush never goes away!

    I'm on my last Diflucan refill currently, and I doubt it's appropriate for me to take it indefinitely for the next 6 months to a year so I can keep breastfeeding. I'm terrified that once I run out, the serious stabbing pain and deep breast pain will come back and I'll have to wean my baby.

    I truly don't know what to do, and I'm so sad and frustrated. I understand the pediatricians see a fat, healthy kid and don't view this as any sort of emergency, but I can't understand why they'd rather do nothing and have him lose out on the benefits of breastmilk than just TREAT THE THRUSH! Basically I've been told the thrush is my problem, not his, so they're not going to worry about it. I'm starting to feel hopeless, especially with this latest attempt at Gentian Violet not working.

    Where do I go from here?

  2. #2
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    Jun 2009
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    Default Re: Thrush - about to give up

    Have you seen an IBCLC? Is it possible you are being exposed some other way aside baby? White tongue is something that is actually common and not necessarily a symptom of thrush. So I wonder if baby might be clear, and that is not the way you are being re-colonized? Yes I know babies can be asymptomatic, I am just trying to troubleshoot a bit.

    Also I wonder if there may be something going on aside thrush? Some other issues might seem like thrush. I realize the fact you feel better after taking diflucan is an indication that it is thrush, however, that does not rule out the possibility something else is also going on.

    If you believe baby needs treatment with diflucan, can your doctor prescribe it or talk to the other doctors for you? You are of course right, obviously, thrush is a big deal because the pain can cause a mom to have to stop breastfeeding and this is harmful to her health and the health of baby.

    Obviously you have read Jack Newmans entire protocol for thrush and tried his suggestions? There may be other protocols you can try. Also, moms on here have reported contacting Newman personally to get his input.

    The book Breastfeeding Answers Made Simple has a longish entry on thrush that includes many details about how re-colonization might occur and precautions to take. An IBCLC or a LLL Leader may have this book and can share that info with you. I have not been able to find it online, but the author is Nancy Morhbacher and she has a blog.

    Recently on a online discussion a respected IBCLC suggested mom see a dermatologist for topical issues that do not abate. She reported they can be helpful both in more accurately diagnosing and in offering alternative treatment.

    I am sorry you are going through this. Sometimes you just want to over the lack of help some doctors give. At least your doctor is being helpful, but it may take way more insistence on your part to get the pediatrician on board.

  3. #3
    Join Date
    May 2017
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    Default Re: Thrush - about to give up

    Quote Originally Posted by @llli*maddieb View Post
    Have you seen an IBCLC? Is it possible you are being exposed some other way aside baby? White tongue is something that is actually common and not necessarily a symptom of thrush. So I wonder if baby might be clear, and that is not the way you are being re-colonized? Yes I know babies can be asymptomatic, I am just trying to troubleshoot a bit.

    Also I wonder if there may be something going on aside thrush? Some other issues might seem like thrush. I realize the fact you feel better after taking diflucan is an indication that it is thrush, however, that does not rule out the possibility something else is also going on.

    If you believe baby needs treatment with diflucan, can your doctor prescribe it or talk to the other doctors for you? You are of course right, obviously, thrush is a big deal because the pain can cause a mom to have to stop breastfeeding and this is harmful to her health and the health of baby.

    Obviously you have read Jack Newmans entire protocol for thrush and tried his suggestions? There may be other protocols you can try. Also, moms on here have reported contacting Newman personally to get his input.

    The book Breastfeeding Answers Made Simple has a longish entry on thrush that includes many details about how re-colonization might occur and precautions to take. An IBCLC or a LLL Leader may have this book and can share that info with you. I have not been able to find it online, but the author is Nancy Morhbacher and she has a blog.

    Recently on a online discussion a respected IBCLC suggested mom see a dermatologist for topical issues that do not abate. She reported they can be helpful both in more accurately diagnosing and in offering alternative treatment.

    I am sorry you are going through this. Sometimes you just want to over the lack of help some doctors give. At least your doctor is being helpful, but it may take way more insistence on your part to get the pediatrician on board.
    Thank you for the reply. I haven't seen an IBCLC, would that be helpful? I've been focused on seeing people who can prescribe us something, since none of the non-medical remedies are working. I know it's normal for babies to have a white tongue just due to eating milk all the time, but my understanding has been that if the white coating wipes off it's just milk, and if not, it's thrush. The coating on my baby's tongue will not budge when wiped. I can't think what else would be exposing me to it - I spend almost 100% of my time topless at this point since I'm home on maternity leave with the baby, so it wouldn't be a bra or nursing pads or anything like that.

    I don't think my obstetrician can prescribe Diflucan for the baby since he's not her patient, and I've tried arguing with his pediatrician to no avail.

    I'm considering switching to exclusive pumping for a few days to try to stop the back and forth cycle and see if we can both get sorted out. Otherwise I'm fresh out of ideas and hope.

  4. #4
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    Default Re: Thrush - about to give up

    An IBCLC is the only professional who is trained in assessing and solving breastfeeding issues. So yes, I think it is most likely to be helpful to see an IBCLC.
    Breastfeeding issues are tricky, as you have discovered, and of course not every IBCLC is great and not every one is going to be the right fit for you. But you can say that about any profession.

    Here is an article about what a consult with a good IBCLC would basically consist of: http://www.cwgenna.com/lconsult.html Before hiring an IBCLC you can talk to her about her experience with the issues you are having, her methods, etc.

    The coating on my baby's tongue will not budge when wiped.
    Thrush classically presents as white blotches or patches that can be rubbed or gently scratched off, presenting as red or bloody underneath. Some babies just have a white tongue surface. I do not know if it is from milk or not, but in my experience it does not always just rub off.

    If you pump and bottle feed, of course be aware how carefully you would have to clean the pump, the bottles, the nipples, etc. Also be careful as several days of no nursing at all might lead to breast refusal. Also, if you are right and your baby has thrush that is going essentially untreated, what good is it going to do? I would strongly suggest seeing an IBCLC if that is at all possible before trying this idea. If you do not know how to find an IBCLC locally let me know.

  5. #5
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    Default Re: Thrush - about to give up

    Ventian Violet often works when the anti-biotics don't or won't. Or will work in combinataion with them. I am going to have Carm come talk to you. She and her 2nd baby had it pretty continuously for the 1st few months. Please don't give up. If your baby is happy and healthy and it's not bothering him, don't let it be the reason you quit nursing. And don't focus on a remedy that your docotor is hesitant to give you. If the doctor is concerned that your child is too young or there are possible side effects-take that advice. Especially if NEITHER of you are experiencing pain or symptoms right now and you ARE being treated. I would 2nd the reccomendation to see an IBCLC simply because you are putting a lot of thought and worry into his white tongue and it could be thrush, but it could not be. Either way, if it is thrush, adding Venitian Violet to the mix can't hurt. Although you will both probably be a little purple for a bit.

    Way too lazy for formula

  6. #6

    Default Re: Thrush - about to give up

    I'm going through the same thing. We have had thrush since my baby was 2 weeks old as well. I was treated with diflucan which works and my son was treated with nystatin. It didn't work. I finally convinced the piediatrician to give him diflucan as well and if cleared us up. Well my son had an ear infection, got on antibiotics and the thrush returned. I'm now struggling with getting rid of it again and the doctor will not give my son the diflucan again because his toung isn't white anymore so I keep getting reinfected. It seems like an endless battle. My son will not take a bottle though so I will not be giving up breastfeeding nor do I want to but it is just so frustrating. My son is now 4 months old.

  7. #7
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    Default Re: Thrush - about to give up

    First off... for sticking it out - it can be so frustrating and all-consuming trying to puzzle out what's going on, and doing all the treatments and washing that come along with thrush. I've definitely been around the block with it, and it really does suck...but can be beaten. So I'll share what I did with my 2nd baby, cause it did take some figuring out. I recognized the symptoms fairly early on because I'd had it with my 1st baby, so I asked my doctor for diflucan and he was good enough to prescribe it. My daughter didn't really have any symptoms, though she did always kind of have a whiteish tongue, but no thick white patches or anything. Anyways, I did a few two week courses of diflucan and it would help a little, but never all the way. My doctor also didn't want to do any treatments with the baby, so I was sticking with the diluted GSE swabs, and the GV, which helped a bunch the first time we did it, but again didn't get rid of it all the way. On subsequent attempts I didn't find it to be as helpful. I tried those silverette cups, vinegar, airing out, you name it, I tried it! Sometimes it would feel like it got a little better, but then would come back in full force.

    I should mention that we did have issues with tongue/lip tie and did get those revised around 8 weeks. It didn't make a huge difference right away, but I think over time it did. I think it is a good idea to see an IBCLC, for a couple of reasons -1) they can help determine if there are any mechanical issues, especially since you started so early on with the thrush troubles, you probably never had much of a 'normal pain free' stretch of nursing to know that things were good in the latch department, and 2) it gives you ammunition to take back to your baby's pediatrician, ie 'the IBCLC that I saw suggested this' and it might cause your doctor to reconsider treatment if indeed it's warranted.

    Anyways, back to what finally worked for me. I was fed up after 5 months of this ridiculousness and went back to my doctor. We did a culture (didn't show anything), but he agreed to give me a month's worth of diflucan anyway. But the big difference was when I really started treating the vasospasms that I was having because of the thrush. Do you have those at all? When your nipple blanches (turns white) after nursing, though it can be that it turns dark red/purple. My local LLL leader suggested that I follow Dr.Newman's protocol for vasospasms to see if that helped, and it totally did. I was taking magnesium and vitamin B6 twice a day, using warm compresses all the time after nursing, and that along with the month long diflucan, and using APNO finally did the trick. I did not have to treat my baby with anything else. So I think it's definitely worth checking that out. https://www.breastfeedinginc.ca/info...ds-phenomenon/

    One other thing - do you have the correct antifungal in your APNO? It must be miconazole. Many doctors (my OB included) will subsititute clotrimazole or nystatin instead, but these don't work nearly as well. Getting my GP to write me the correct one actually did make a big difference.

    Hang in there mama. I know while you're in the thick of it, it feels like it'll never get better. But it can, and I really want to encourage you to keep at it. It is so worth it. And now, I've been pain free for almost 6 months, and it is amazing. Knowing that once I got past it nursing would be the best thing ever really gave me the strength to keep fighting it!

  8. #8
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    Nov 2016
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    Default Re: Thrush - about to give up

    I want to give you some hope! I went through the EXACT same thing starting at 2 weeks! The Nystatin did nothing, The GV worked the first time but only for a couple weeks, and then made it worse the second time. I ended up just leaving baby's tongue alone since there wasn't any more I could do (my dr. wouldn't give Diflucan either) and used the Clotrimazole cream on my nipples twice a day (the anti fungal part of the APNO cream) and that took the pain away for me. I just had to keep using it. Same as you- if I stopped, the pain/itching would come back. I also took probiotics myself.

    Then around 10-12 weeks (can't remember exactly) it just went away... on me and on baby's tongue. I don't know if it was just her immune system maturing/ gut bacteria maturing/ nursing less often because she was older/ my probiotics kicking in/ or a combination.. but it's gone!

    So, I wouldn't worry about baby's tongue, just keep your pain down with the cream and wait and see! We are at 7 months now and I'm so glad I didn't quit EBF!

  9. #9
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    May 2017
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    Default Re: Thrush - about to give up

    Thank you all so much for your responses and encouragement. Since my initial post, it appears I just hadn't given the Gentian Violet enough time. I kept up with treatment, and as of today (day 7 using it) the baby's tongue is completely clear! I applied some GV to my nipples as well once I started to see it working, and my nipples are feeling better but not 100% clear yet. I've also incorporated probiotics for myself and the baby - not sure if they're contributing to the improvement or not, but I certainly plan to continue. Hopefully we've turned a corner here - I've actually found breastfeeding quite pleasant during those intervals I've gotten between being reinfected.

    I haven't experienced vasospasm, so I don't think that's contributing. The APNO I have probably doesn't have the right anti-fungal in it though - I know my doctor wrote the prescription correctly, but for some reason the pharmacy was adamant about using a nystatin/clomitrazole combo anyway. I asked the doctor to tell them no substitutions, but who knows if they listened (when I picked up the prescription the person mentioned that they always have a bunch "ready made" so it wouldn't take long, presumably using their preferred recipe . . .)

    One question for those of you who've had thrush and beaten it, how long does it take for the angry red/pink color to fade from your nipples? If there's still some pinkness, but not as dark, should I be concerned it's not all the way gone? (My nipples and areolae are usually dark brown, so any pinkness at all is out of the ordinary for me, but I don't know how much of that to attribute to thrush vs. just breastfeeding itself.)

  10. #10
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    Default Re: Thrush - about to give up

    I'm so glad to hear the GV seems to be doing the trick! As for the correct antifungal in the APNO, you need a compounding pharmacy to put it together. So if that's not something your pharmacy does, then you're probably right about it being the nystatin/clotrimazole. It's good that you don't have vasospasms too, it's just an extra pain (literally!)

    In regards to nipple colour...to be honest, I'm not sure I could tell you how long it took. As long as you're not having blanching though, I wouldn't pay as much attention to the colour of your nipples so much as to whether you're having pain. I'm not even sure I remember what my nipples looked like before I had babies lol!

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