I have a client (an MD) who has had chronic yeast infections for years and
has been diagnosed with Vulvo Dynia. Estrogen helps the symptoms.  When she
was pregnant, she was symptom free but since the birth she experiences
severe vulvar pain.  Her OB calls it atrophic vaginitis caused by low
estrogens when she is breastfeeding. She feels that the mom's hormones are
historically out of balance.

Mom has found that with changing her diet for colic symptoms in the
baby--eliminating dairy, wheat and eggs--her symptoms are lessened.  But
what helps the most is estrogen cream (Estrace) which she applies sparingly
every 4-5 days.

3-4 hours after applying the cream, baby  (6 1/2 weeks old) appears to
taste a difference in the milk and will feed with agitation and discomfort.
She continues this fitful feeding for several feedings, not emptying the
breast.  Mom pumps the rest of the milk.  Then after about 6 hours baby
will feed well again, but suffers from severe gas pains for another 6-8 hours.

Once when baby was left with Grandma with a bottle, which she usually takes
well, baby rejected the bottle of milk. This milk that she rejected was
pumped during the "Estrace" period.

Mom wants to breastfeed for at least a year, but doesn't know if she can
stand the pain for that long.  She wondered about pumping a supply on the
"good" days to give baby during the problem hours after she has used the
Estrace.  Or if there is something else that could help her condition that
would be less problematic for baby.

I suggested working on her yeast problems and she said that she had thought
of that and got a prescription for flucanazole (Diflucan) but she and baby
had bloating and severe gas pains for 24 hours, so she sees that as a drug
sensitivity, (It could be toxins from the yeast die-off.)and doesn't want
to use it again.

She has tried to restore balance to her GI tract over the years with
alternative and conventional treatments, but was unsuccessful.

What is interesting is that she didn't have nipple/intraductal yeast
overgrowth.

I thought that yeast infections were *more* common during pregnancy.  Could
there be something else that she did/didn't do during the pregnancy that
eased the symptoms?

What do you think?

Pat Gima, IBCLC
Milwaukee, Wisconsin
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