Hi all,

I am talking with a mum with what sounds like recurring or persistent
thrush. The whole thing started with antibiotics at a c-section birth
and every time she takes a course of antibiotics, symptoms return.
However, there are a few confounding factors.  Here are more details in
her words:

"I assumed it was thrush, and began a 2-week course of topical 2%
miconazole
cream for myself, and nystatin qid for my daughter, along with all the
usual precautions - boiling all applicable pump equipment for 20
minutes,
changing disposable nursing pads frequently, etc.  However, also
coincidentally, at that time, my period (which returned when Emmie was 4

months old, and had been regular for 3 cycles) was 2 weeks late. So I
thought, maybe the pain was from an unsuspected pregnancy, and took a
HPT
(negative). The pain eased off when the period began, a few days after I

began the miconazole."

"After the miconazole treatment was over, the pain came back. This time
I
took a 10-day course of Diflucan (200 mg X 1 day, 100 mg X 9 days). The
pain eased off, though never entirely.  But I was still doing side-lying

nursing at night. I thought maybe it was poor positioning."

"Now my period is 10 days late again, nursing hurts so badly I can
hardly
stand latch-on, or the thought of the next feeding. I'm using miconazole

cream again, to no apparent effect."

"I can find no cracks in either nipple. I do not have any significant
feeling of 'burning' between feedings, as I had the first time. I have
no
rash, and my nipples are not particularly pink or red, if I go without a

bra touching them for a while, at home (though they do look red, if the
nursing pad has been pressing the nipple in for a while, inside the
bra).
My daughter has neither diaper rash nor visible thrush in her mouth.
I've
stopped side-lying nursing.  I do have recurrent plugged ducts, which I
know can be associated with yeast, but I've always gotten those, nipple
pain or no nipple pain."

I don't know what to do.  I really want nursing to be pain-free again. I

don't trust my GP to give me really up-to-the-minute breastfeeding
advice,
and I don't know what help my OB can give me."

Since she first contacted me she mentioned she had started using gentian
violet and the pain eased on the third day of treatment, so should she
stop using it after 3 days or use it along with diflucan? Are the
plugged ducts contributing to the thrush problem or is it the other way
around? Why are her periods 2 weeks late for the last couple of cycles?

The baby is 9 months old and the mum has no intention of weaning but
would like nursing to be pain free again. She mentions the pain is worst
at latch on and then fades to a bearable ache. No pain between nursings.

Thanks,
Donna Hansen
Burnaby, British Columbia