Wednesday, December 12, 2012

Thrush and My Story

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:
Thrush is horrible, so I write this hoping it may help another struggling mom.  I was so thankful for my friend Christina and her support.  She had thrush for 6 months with her youngest daughter.  If you have any questions or just need to vent, feel free to contact me.


Anonymous said...

Wow, Amber. I'm so sorry you had to go through that. Thanks for posting about it - I'm sure it will help other moms, and I feel informed as I'd never heard of thrush (I haven't read a whole lot on breastfeeding yet in my life, but will need to, I hope). I will be praying for your strength and recovery. So thankful God has allowed you to be home while walking through this.

Unknown said...

Wow this makes me wonder if that was not my issue with my second son. I was so engorged and yet he could not seem to get anything, not even if I pumped. But the pain you describe and the itchy nipples I had all of that. I finally switched to formula because he was losing too much weight but spent WEEKS suffering from the mastitis as they called it and my water bill was through the roof because I would spend all my time under hot water in the shower trying to get them to go down.

Amanda said...

Holy moly!!! That is one intense regimen! I bet you were going crazy! I really, really hope that you all have beaten thrush. Briefly, I had a small nipple fissure that was VERY painful whenever C nursed. I had to stop nursing on that side for 1-2 days and pump. My doctor called in a "magic" triple ointment recommended by the lactation consultant. It had an anti-fungal, an antibiotic and something else in it. It healed up so fast after I got that ointment and gave it time to heal. (Plus C's latch finally got better by the 2nd week.) I am so thankful it didn't turn into mastitis or thrush. But that side still makes way less milk than the other. I have no idea how you were able to maintain your supply through all of this. Good job, mommy!

Nate and Molly said...

I really admire your perseverance. What a gift you are giving to Zoe at great personal sacrifice!

Us said...

Sheesh Amber! I'm so sorry you had to go through that. I'm crazy impressed you've persevered. With Sadie I was plagued with clogged ducts (finally figured out that when I pulled over my stretchy sleep bra to feed, the fabric was pressing on my ducts and caused the problem). I can't imagine it being worse than that and the initial nipple pain. Praying this seriously intense intervention will nip (haha) it in the bud.