Michelle
I am sorry that I am posting all about safety of diflucan when I think I get
it now that you are wondering about transmitting THRUSH to the baby! Do I
have it right this time? I went back in the archives and read your original
post and I think now I understand what you are getting at.

From my reading of lactnet over about 4 yrs, reading from the thrush experts
and from Dr. Newman, my opinion is I am not convinced that the baby will get
thrush from the milk. I know we believe that thrush may not be killed by
freezing, but again, the risk:benefit picture would be TO ME in favor of
using human milk instead of artificial for this little premie.

I have read of mom's using their milk and baby not getting thrush at all,
also some mom's have it and baby doesn't, and not all docs will treat the
couple together, so I have seen where one gets it and the other doesn't. I
know that with really chronic thrush, some LCs recommend dumping the milk
that is expressed during an infection w/ thrush. I don't think we really
have an absolute answer on whether to give the milk, and if so, when to give
it after treatment begins. At least, I do not feel I have a clear answer.

Would the milk also contain antibodies to the thrush infection? I will admit
that I have seen systemic candida infections in premie babies with
devastating results, and they had to take amphotericin B, which is really
toxic, so there is no easy answer. Could the milk be tested, viewed
microscopically, to see if candida is present? Would the candida be seen on
a slide?

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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