Hi everyone,
I have permission to post this moms questions which I have received 
today.She is very committed to breastfeeding but needs some advice for her 
many challenges. Can you help me to help her ?
Her is her story.
I have an awful problem with blocked ducts.  I got mastitis when she was 3 
wks old and since then I have had 4 more blocked ducts.  She's now 2.5 
months old.  I just started taking 2tabs of lecithin 1200mg QID today (I was 
only doing 1 tab before).  As well, I'm not wearing a bra to bed and wearing a 
very loose one during the day.  I'm also going to purchase some evening 
primrose oil as Dr. Newman says he suggested in one case that worked.  I 
wondered if you might have any other suggestions for me.  Will it ever get 
easier?  I've gone for u/s therapy for the last 2 blocked ducts I've had and had 
2-3 sessions each time.  The blockages don't resolve immediately after the 
u/s, but they will normally resolve in about a week from when they started. I 
try to apply moist heat prior to feeding her and massage while she is feeding 
being sure her chin is pointed onto the blockage area, if possible.  Currently I 
have a blockage in both breasts which is so discouraging.  It has only been 
occurring on one side up until now.  Any other preventative measures you 
might suggest?
As well, I am at my wit's end with thrush!  I think I have tried everything!   
She has been on treatment for thrush since she was 2.5 weeks old.  She must 
have picked this up in the birth canal and at 3 weeks of age, after she already 
had this infection, I developed mastitis and had to be put on antibiotics, only 
perpetuating the problem.   I have consistently been washing my nipples with 
vinegar and water after every feeding and have been regularly applying 
clotrimazole ointment afterwards.  Now I'm using Dr. Jack's cream.  My baby 
started out on nystatin at 2.5 weeks of age and took that until she was 6 
weeks old (1ml 4x daily).  This was simply not working at all, so I tried gentian 
violet at 6weeks of age and she took this twice daily for 3 days and then once 
daily for 2 more days as suggested by a lactation consultant.  Unfortunately, 
this did not do the trick either.  I talked to my doctor and he agreed to put me 
on diflucan as you suggest in Dr. Jack's book and he prescribed me the 400mg 
loading dose and then 100mg twice daily for one week(but later I realized it 
was supposed to be one week, totally pain free.)  This seemed to help initially 
and I was ecstatic!  However, I foolishly stopped applying the clotrimazole 
ointment for a few feedings on day 3 or 4 and only washed with vinegar and 
water, as a lactation consultant mentioned that this ointment could really dry 
out my nipples and I had recently noticed they seemed to be quite dry... 
though not uncomfortable.  After the breast pains started coming back I 
immediately restarted the ointment, but it seemed my baby's white tongue 
started becoming more white again after this. As well, my breast pains, though 
they had ceased, started again.  (I could kick myself!).  Anyway, while taking 
diflucan I was applying nystatin again to my baby's mouth, but this didn't seem 
to be helping.  Last week I started a second attempt treatment of gentian 
violet - once a day for 7 days, which is done today, but her tongue remains 
white (ok, it's purple on the white to be more accurate :).  Last week I also 
started another treatment of diflucan and will stay on this as Dr. Jack 
suggests... at least one week pain free. 
 I've ordered some grapefruit seed extract by "nutribiotic" and it'll hopefully be 
here by the end of the week.  Anyway, I'm also taking lactobacillus 3 tabs, 3 
times daily, and I've been on a totally yeast free diet for the last week.  
Nothing seems to be working! 
 I should also mention that I have an overactive milk ejection reflex... she 
does a lot of tongue clicking during letdowns and I often try laying down, 
which doesn't work all that great.  There's probably nothing I can really do 
about that except accept her tongue clicking though eh?  I think this 
sometimes contributes to her latch not being as good as it could be. 
 
Thanks as always,
Kim Scott
RNBN IBCLC
Miramichi NB
Canada

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