Yes, recurrent yeast can be a sign of diabetes in adults, but oral thrush
generally isn't considered indicative of anything serious in babies.
Now for my question/problem case:
Mom of a now 5 month old boy has been battling apparent ductal yeast since
birth. Had c/s and intrapartum antibiotics for group B strep. She got
sore nipples with shooting pain and vag yeast, baby got thrush. Treated
with gentian violet (both of them), got better, then got worse. Treated
with Nystatin for both. Got better, then got worse about 3 days after
finishing the course. Figured it must be a resistant strain of candida, so
treated them both with Diflucan. Got much better. About a week after
finishing the course, mom got mastitis and was treated by her OB with
Keflex over the phone. (I'll stay off the soapbox about that one.)
Naturally, she started having the shooting breast pain again. Baby's mouth
stayed clear, but I treated them both with another round of Diflucan for
two weeks. Pain went away. Then, mom had a kidney stone and infection
while visiting relatives in Denver. (She commented on how
breastfeeding-friendly the hospital and physicians were!!!) Another
antibiotic, this time by IV for a week. Breast pain returned. Another
treatment for both with Diflucan gave good results, but was not totally
pain-free by two weeks, so refilled the Rx. Baby's mouth stayed clear.
Have tested Mom's glucoses several times to rule out diabetes, and all have
been normal. Checked a CBC to rule out other unknown immunodeficiency, it
was normal also. Mom has also been "mostly" following Pat Gima's yeast
treatment plan: she's been using the vinegar rinses, doing the laundry
recommendations, avoiding dairy and "most" sweets in diet and using
acidophilus. Mom's liver functions also normal, so all this Diflucan not
having any adverse effects there. Husband/father has also been treated
with these last two courses. Not using any bottles or pumping; pacifiers
have been replaced. Baby doesn't go to daycare. Seems no matter what we
do, mom has nipple/shooting breast pain unless she's on Diflucan. Baby is
thriving, only occasionally gassy, hasn't had yeast diaper rash since the
time he also had oral thrush. (Mom uses a Tea Tree Oil rinse for diaper
changes instead of baby wipes.)
Any thoughts appreciated. Mom is determined to nurse this baby a year,
even if she has to stay on Diflucan the whole time to do it. She also
laughs that if anybody needs encouragement to keep going when they've got
"just the regular kind of sore nipples" I should have them call her. Dad
is very supportive.
Thanks for any and all help!
Becky Saenz,MD,IBCLC
Jackson, MS, where the hot humid climate doesn't help!
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