OK everyone!!
I'm going to play devil's advocate here and ask why thrush in the
breast is so incredibly hard to get rid of.
We spend a lot of time telling mothers how many anti-infective agents
human milk has in it, and how it kills off all sorts of germs and
protects babies from infection. So how come that candida can get such
a foothold, and be so hard to get rid of???
The doses of fluconazole used by some Lactnetters are pretty generous
- 200mg per day for weeks on end (something we Aussies can't afford).
These are the sorts of doses that are otherwise used for patients
with terribly damaged immune systems who have huge thrush attacks (eg
HIV).
How is it that otherwise healthy young women get such terrible
trouble in a part of their body awash with the wonder-drug human
milk???
Maybe some of these mothers don't have thrush, and tincture of time
fixes things in the end, rather than the nystatin, miconazole,
fluconazole, gentian violet etc etc. The subtle attachment problems
that could mimic as thrush can easily rectify themselves in the weeks
that it takes to 'cure' a perceived thrush infection.

Please don't flame me!! I treat thrush, and have seen benefits in
some women, and frustration with others. I'm still not sure that I
can confidently diagnose the problem, and can't understand why this
seems so difficult to treat in some women.
Any thoughts??

Merry Christmas
Fiona


Fiona Coombes MBBS IBCLC               [log in to unmask]
Lactation Consultant, Family Physician
Perth Western Australia