Before we start a new craze for tea tree oil, a caution. Adelaide
allergists consider it to be one of the most potent sensitisers they've
dealt with. Reactions can be intense and severe. No, they haven't published
yet, this was at a conference. And oils on used on breast skin 1) are
rarely a good idea (read the literature re oils, creams etc or ask the
moist wound healing people about oils) 2) need to be edible (what is the
fatty acid composition of ti-tree oil? are those fatty acids good for
babies?) 3) need not to be so hideous tasting as to induce breast refusal
(try anything you plan on feeding your baby).
Re gentian violet:despite the established fact that large quantities fed to
mice gave some of them liver cancer, I still use it and still find it
better, cheaper and faster than anything else for topical treatment of
thrush anywhere on the female body. .05% aqueous only (dilute stronger
solutions with sterile water if you need to; it shouldn't sting as the
alcohol content is so low. Applied so that it penetrates all the crevices
on the nipple it does not need to be endlessly re-applied for days or weeks
as it achieves total kill of all thrush it contacts; a follow-up treatment
a week later gets any newly-germinated spores. Irritation, itchiness and
soreness decrease almost immediately. It's not like an antibiotic where a
full course should be taken to avoid developing resistant strains: it's a
contact fungicide. I have not heard of any allergic reaction to g.v. I have
also not heard of any useful medication that was banned on the basis of
mouse studies alone other than g.v. I was astounded to read when the ban
was first imposed, that the US FDA allowed g.v.'s continued use for skin
marking by surgeons, and for another essential purpose: use in
confectionery, because industry protested that there was no other purple
that worked as well. has this changed? Is it now banned in lollies for
internal consumption by children as well for external application on adult
skin? If not, one has to ask how seriously it is seen as a carcinogen by
anyone other than the makers of more expensive medications... And I have
seen numerous sensitivity reactions to daktarin gel, which here in
Australia has replaced g.v.
My only concession to the g.v. cancer information to date is 1) full
information for mothers; 2) treatment modality: suggest they apply a single
good dose immediately after the feed that is most likely to have a
long-inter-feed interval. Leave it sit as long as possible; wash off the
excess dye before feeding baby next time. This reduces the dose to baby,
though I doubt that's significant when there has been no evidence of human
carcinogenicity despite decades of heavy use. Still, it's a coal tar
derivative I understand, and probably all of them are carcinogenic to soem
degree. But then have we fed large amounts of all the g.v substitutes to
mice in comparative trials, or set on foot any human research?
Unilateral thrush: dead common in cases of fissure. Each nipple is a
different environment. When a fissure has developed on one but not the
other, thrush frequently colonises the fissure (a favourable
micro-environment) and prevents healing (as Gunther said decades ago). It
can be transferred to the other breast, or the baby's mouth and the
mother's breast may not provide a suitable environment for thrush to grow
sufficiently well to cause any symptoms. Irritable skin may be an allergic
superficial reaction to transferred fungal toxins, not evidence of
epithelial infection per se. Sometimes the only sign of thrush is a tiny
white pinhead or flake in a nipple crevice that is not frequently bathed
with breastmilk, and the mother's report of itchiness on that nipple.
Breastmilk being anti-fungal and anti-inflammatory, it sometimes requires
skin trauma or favourable topography before thrush can get established on
the second breast as well. I don't suggest treating both nipples unless
both are symptomatic.
Well said Kathy Dettwyler re the Ezzo propaganda. We haven't been subjected
to that here as yet, but no doubt it will come. I object strongly to any
misuse of Christian (or other religious/historical) literature by persons
unwilling to learn historical method, textual criticism or biblical
exegesis.
Maureen Minchin, IBCLC Melbourne Australia
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