~~~~~~~~~~~
To Rebbecca:

Yes, yeast infections can be persistent, especially when they have continued
for years.  I have two suggestions, especially as you've said the mother has
tried already so many remedies and is being extra-cautious about hygiene.
1) Check and treat other sites on the mother and treat the family.
2) Is it really yeast?

1) Treating other sites.
a) A few years ago I had a mother whose nipple thrush had occurred in a
previous lactation, not been fully resolved, and had flared again with the
following pregnancy.  it was proving persistent. Examination found that she
had a nailbed fungal infection (toes) and when I showed her this, she told
me that two of her children also had nailbed infections.  Discussion
revealed that the probable link was the family's very old tiled shower.  My
recommendations for treatment were to treat all sites, to expect it to take
time since there was such a long history, and to treat the shower stall.
Besides using Clotrimazole on the nailbed infections, I recommended she soak
the feet of all affected family members in water with (about) 5 drops of
lavender oil and/or 2-3 drops of tea-tree oil per 500 ml.  By doing that in
the shower, it would serve to apply antifungals to both the feet and the
shower.  Then apply the clotrimazole. The mother realised she needed to take
extra care with cleaning the shower. There are commercial antifungal
cleaning agents that can also be used, which came on the market after I saw
her.
b) Another mother had a ringworm on her thigh, right where her hand rested
when she was sitting.  So I gave her a leaflet about treating ringworm with
topical antifungals (clotrimazole), with added instructions about continuing
the treatment for about 2 weeks after the ringworm disappeared.  Treating
the nipple thrush and the baby's mouth would have been ineffective without
treating the other fungal site, as the mother would unconsciously have
touched it and reinfected her nipples with her hand.
c) I also try to remember to broach the sensitive issue of the partner, as a
possible site of oral thrush or "jock itch" (genital area).  Oral thrush
from the partner is another way the mother can be reinfected, i.e. during
sexual foreplay.

2) Is it really yeast?  If the mother has been treated for adequate amounts
of time using a variety of proven treatments, *and* if any other sites on
mother, baby, father, and other family members have been identified and
treated - that's when I start to think laterally and question whether it
really was thrush in the first place.  That's where a re-examination of the
case makes sense, just to be sure.

I hope this helps, Rebbecca. By the way I'm going "nomail" today - pressure
of work.  I can be contacted off list.

Virginia
in sunny Brisbane, Queensland Australia
[log in to unmask]
~~~~~~~~~~~~~~~~~~~~~~~~~

On Tue, 2 Aug 2005 Rebbecca Rosen wrote:

"I have a mother (PTP) of a 7 week old with persistent thrush.  Mom  stopped
breastfeeding first child due to yeast after 3 weeks of age.  Baby  and Mom
have been treated simultaneously with nystatin (one round)  and gentian
violet
(on two different occasions).  The nystatin was  ineffective.  The gentian
violet was effective both times but the yeast has  returned yet again.  I
recommended Culturelle (a lactobacillus) for mom and  baby which they both
have been
using daily.  Mom has been very careful with  hygiene and boiling items such
as
pacifier and bottles (used once a week).   I am having mom tested for anemia
and diabetes.  I have recommended Dr  Newman's cream and a trial of
fluconazole
for baby.  Mom will be calling MD  tomorrow to get these prescriptions.  My
questions are the following.  First, can you have ductal yeast and not have
deep breast pain?  Would  there be any other symptoms that would be present
that
would signify ductal  yeast?  Would a 2-4 week fluconazole trial for mom be
warranted?   Thank you ahead of time for your wisdom."

Rebbecca  Rosen RN, BSN, CBC
[log in to unmask]
~~~~~~~~~~~~~~~~~~~~~~~~~~~

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html