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Subject:
From:
Lisa Amir <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 30 Nov 1995 21:18:56 +1100
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Re: mother with breast thrush using breastmilk for baby's conjunctivitis -
candida may be present in breastmilk and could possibly cause a fungal
conjunctivitis, so I advise women with candida infections not to use it in
baby's eye, and also not to save it (ie it freeze) it for later use.

Re: ketoconazole and fluconazole - we know that ketoconazole (Nizoral) has a
risk of liver problems (enzyme changes and hepatitis) whereas this does not
seem to occur with fluconazole. Fluconazole has a longer half life than
ketoconazole (ie it lasts longer in the body) and is very well absorbed into
all parts of the body. Only one study that I know of has measured it in
breastmilk, and found it to be a similar concentration as in the mother's
blood (Force 1994 - don't have rest of reference). We think this is safe for
the baby, because it is used in neonatal units (see recent letters in the
Journal of Human Lactation:Hale 10:7-8). If anyone knows of other reports of
use of fluconzole in breastfeeding women I would love to hear from them.

Re: breastfeeding woman with burning radiating pain in lower breast - sounds
like thrush to me. There is not always a history of thrush or evidence of
thrush elsewhere.

By the way, if anyone has any comments on the LC Series unit on Candidiasis,
please let me know. Kay Hoover has already made a list of things she wants
to change if we get to have another edition. (I am restraining myself from
making any comments about Avery Press!).

Lisa Amir
GP/LC, Melbourne, Australia

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