Breast feeding Bennett was a struggle from day one. He was extremely hungry, my milk supply was low, and the list could go on. So with Zoe I planned to feed on demand, take Fenugreek early (if needed), and drink tons of water to help my supply. Day one she latched like a champ, but I suspected my supply was low. I worked hard, but still had to supplement with formula during those first few weeks. I was discouraged, but kept pushing through and thanking God for the milk He had given me. Then came mastitis in the left breast followed by several blocked ducts in the right breast. At that point, my supply was good, but she wasn't satisfied, because the blocked ducts prevented her from getting the milk. It had been frustrating, but when I began experiencing burning deep in my right breast in early November I was beyond frustrated. For a few days I thought it would get better, but it kept getting worse. It was beginning to burn for 1-2 hours after she would feed and I was pretty miserable. After a little research, I was pretty sure I had thrush, so I put a call into my doctor.
The appointment confirmed that I had deep breast thrush (candida albicans, aka. yeast). Here are the signs:
- Sudden start of breast and/or nipple pain after some days or weeks of pain-free breastfeeding- the nipple may also be itchy or be super-sensitive to any touch-even loose clothes
- Shooting pains in the breast (may be deep in the breast) after feeding- pain can be severe and can last for up to an hour after feed
- Cracked nipples which don't heal
- Loss of color in the nipple or areola
- Pain occurs in both breast (except in the early stages) because the baby transfers the infection during feeding
I had 2 of 5 symptoms.
The nurse practitioner prescribed:
- 14 days of oral flucanazole which is an anti-fungal (300 mg day 1, then 100 mg 2x/day for 13 days)
- Nystatin cream for my nipples to be applied twice daily
- Nystatin oral gel for Zoe to be administered 3x/day, which was eventually changed to 4x/day. Because thrush can be passed back and forth between mother and baby, the baby must be treated regardless of it he/she shows signs of thrush.
In addition to the medications, I was given a hot pink sheet with other things I needed to do to help get rid of thrush:
- Boil all items that come in contact with my breast milk and my baby's saliva for 20 minutes daily (nipples, breast pump parts, pacifiers, toys, etc.)
- Wash breast pads, bras, and any other clothing that comes in contact with my breast milk or my baby's saliva in warm, soapy water adding 1 cup of vinegar to the rinse cycle.
- Use paper towels for hand washing and only use bath towels once before washing.
- Change toothbrushes frequently
I began treatment and after several days of little change my sister (who also had thrush) and I began researching and discussing additional treatment.
Here is what my daily regimen looked like. I washed all of our clothes on a daily basis adding 1 cup of vinegar (or bleach) to the rinse cycle.
I rinsed my nipples with vinegar water before and after every feeding. After, each daily feeding I applied diluted Grapefruit Seed Extract to my nipples and I dipped a Q-tip in the solution and used it to clean out Zoe's mouth. I also tried to change my breast pads after every feeding.
I stopped eating sugar and yeast heavy foods. I ate plain Chobani yogurt for breakfast each morning, since probiotics help fight yeast in your body. I took one to two doses of probiotics mixed in water daily. I also administered probiotics to Zoe. Originally, I mixed it with pumped breast milk, but after some research I switched to applying the powder to my clean finger and allowing her to suck it off. In addition, I gave her the oral Nystatin 3-4 times per day.
I applied Nystatin Cream to my nipples 2-3 times per day. Prior to going to bed, I applied Gentian Violet to my nipple (it is very messy and stains everything purple) and left my bra/shirt open to keep my breast dry throughout the night.
At the end of every day, myself or my husband would boil all of the items from the day that had been exposed to my milk or Z's saliva.
After 14 days of oral anti-fungal the thrush was still raging, so I was prescribed another 7 days. It has been over a month since I initially began experiencing the pain of thrush and I think I am free of it. It has been so very painful and aggravating. There have been many days when I wanted to stop breast feeding and many that I thought I would have to, but currently I am still breast feeding. It's funny, because as I write I have another blocked duct..............who said breast feeding was easy!?!?!?
Here are the links I found most useful:
- Ductal Thrush and Breastfeeding
- Grapefruit Seed Extract- Gives specifics of dilution and other information
- General Information (very helpful)
- Gentian Violet
- Diet and Diet-do more research if breastfeeding