My understanding is there is not a lot of evidence to support ductal
thrush, and that Big Names in lactation support are doubtful that it
exists.
I also understand that it would be very unusual indeed for the
symptoms you describe to be thrush, and that early days postpartum
pain in the breast can often be amended with attention to
positionining and attachment.....it's certainly what most of us in
the UK look at before thinking of anything else.
You can download info about thrush that we use here:
http://www.breastfeedingnetwork.org.uk/leaflets-and-publications.html
There are some references with that info, but I don't think there are
any that really 'prove' ductal thrush.
Having said that, very occasionally, I come across a mother whose
persistent breastpain only resolves with treatment of mother and baby
for thrush - whether that means the mother had ductal thrush I don't
know of course.
Personally, though I am not an HCP of course, I would not be wanting
a mother 5 days postpartum to be medicating unless it was absolutely
necessary. It's not just that this might be ineffective or even risky
(though there are risks with any medication). It's more that
medicating makes a 'patient' out of the mother, and does not support
her confidence in her body and her breastfeeding. I accept this is
partly a cultural view, and we Brits use less pharma 'stuff' of all
types, and don't expect to be medicated as much - I know it's not the
same everywhere.
The pain the mother is suffering obviously needs investigating, but
it could be a number of things - I'd also be looking at how she was
sitting/lying/holding the baby, and seeing if her doc could explore
other reasons for the pain.
Heather Welford Neil
NCT bfc, tutor, UK
>Hello Wiseones
>
>I was asked to see a women, who was 5 days postpartum today, because
>she had deep breast pain. Primip 34/40 gestation NVD
>I did notice that both her nipples looked bruised or slightly purple
>she reported that they always looked like that.
>She described tingling and breast pain that started on her right
>breast, and was now in her left breast but not as painful(I did talk
>to her about the Mammary Restriction Syndrome) even when she was
>wasn't feeding or expressing she had pain, when she was lifting her
>arms.
>Her nipples didnt appear to have a shiny look but did appear
>slightly red. She also reported that she was very susceptible to
>Thrush
>When I showed the specialist the recommendations from the
>Breastfeeding Answer book, he was very angry and suggested that
>Lactation Consultants were over the top, and we were intervene when
>we should leaves things alone. He also said it was a trendy
>diagnosis.
>He also suggested that the recommendations from the book, could
>cause brain damage, and he wanted a copy of the recommendation and
>he was going to take it further:{
>He did prescribe 150mg stat dose of Fluconazole, and he did
>apologise for yelling at me:}
>So now wiseones, can anyone give me research articles that I can
>read and pass on to him.
>
>Sincerely
>
>A bit battered and bruised
>
>June Nicholls
Lactation Consultant
--
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