I have two women I have counseled numerous times over the past 2 years who
have a similar problem. Both are first-time mothers, currently nursing a 2yr
old, both boys. Both mothers had a history of systemic yeast before
conceiving, but only one had recognized it as such and made dietary changes
(which she abandoned during pregnancy).
    Neither mother had nipple or breast pain related to thrush immediately,
but both developed such pain within a couple/several of months of birth. Both
mothers are vegetarian, one is also recently vegan. Mother A had a homebirth,
no interventions to her or baby, neither has had any antibiotics. Mother B
had a cesarean, baby was in NICU on iv antibiotics for one week. Neither has
ever had artificial baby milk. I have been involved w/ both since birth and
both have used correct position, latch, etc from beginning (or as soon as
corrected).
    Mother A has done the following: dietary restrictions involving
elimination of all foods she and her son seem sensitive to, including sugar,
wheat and gluten, bananas, fruit juice, chocolate and all non-vegan foods.
She has worked w/ an allergist who confirmed that she has yeast. He has ruled
out psoriasis and excema. She has used the following topically at various
times: tea tree oil, vinegar, lansinoh, a comfrey salve from a naturopath.
She has taken supplements and an herbal preparation from the allergist called
tannelbit which helped for a while. She has used homeopathy, which has also
helped some. She takes a probiotic formula, too. All of these things have
helped enough to keep her nursing, but her nipples look awful, she has
temporarily weaned and then resumed on one side at several points due to pain
and trauma.. Her nipples are extremely dry and bright pink and shiny. The
areola looks almost keratinized to me--the skin seems dense and not as
pliable as normal. Her nipples seem to almost spontaneously crack open
periodically, esp where the nipple meets the areola. Her son nurses correctly
and has had a great deal of bodywork (chiropractic and p/t, including
cranial-sacral work, which corrected poor nursing early on). She did have
cracked nipples in the early days, which seemed to heal completely at the
time. She has not used gv b/c her nipples are so *extremely* dry already. The
son's diaper rash has come and gone also.
    Mother B has tried nystatin, vinegar, gv and dietary changes. She just
returned from a week away from her son and says he is nursing correctly, but
her nipple cracked open from nursing.
    Both women believe they still have systemic yeast, although mother A
feels it is better. I am wondering if there may be something else going on
here. Both mothers want to continue nursing and neither prefers to use drugs.
Pain is primarily limited to the nipples and areola (both women have
moderately small areolas).
    Both women have resumed menses, neither is pregnant. Neither has vaginal
yeast symptoms.
    I'm sorry this is so long, but I know there is a common thread here and
both mothers have truly suffered w/ nursing at times. Mother B wants to be
pregnant soon and fears doing so b/c of this. Can anyone help? TIA.
Jennifer Tow, IBCLC, CT, USA

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