Pat, I have found that, for most women, antifungals alone do not resolve
yeast overgrowth.  Diflucan can kill off the yeast, mom feels better, but
within a few days the symptoms are back with a vengeance.

What we are doing here isn't trying to stamp out yeast once and for all.
We want to restore balance between yeast and the beneficial bacteria that
live in our systems. When a mother has repeated yeast infections and baby
has on-going symptoms of thrush, she needs to help the bacteria side of the
equation. For some women it takes diligence and attention to consistent
treatment for weeks (some months) before health is restored. This healthful
balance *can* be restored, however.

One of the most important things to remember is that nipple, intraductal,
and oral yeast are part of the bigger picture of systemic yeast overgrowth.
A mother will experience recurrence until she restores balance.  This
recurrence is quite emotionally depressing, especially if she is having to
do battle with a disinterested physician at the same time.

Here are the adjuncts to antifungals that I recommend in my yeast treatment
plan.  My plan is extensive, but effective.  I have gleaned the
recommendations from 5 years of experience, conference sessions, books,
and, of course, Lactnet. This list is the skeleton of my protocol.

I begin with Gentian Violet if mom will agree to it. I also use it
sometimes in conjunction with oral antifungal.

Oral antifungal for at least 2 weeks.(both mom and baby)

Antifungal cream for nipples and diaper area of baby

Vinegar water

Acidophilus

Garlic

B complex vitamins

Echinacea

Elimination of dairy

Greatly reduced sugars

And *all* of these complimentary treatments are continued religiously for 2
weeks after all symptoms are gone.  This is the hard part--except for
mothers who have had a recurrence.

I take yeast overgrowth in mom and baby seriously and stress to the mother
the importance of restoring her and her baby's systems to health, not only
to save the breastfeeding relationship, but for optimal general health.

Patricia Gima, IBCLC
Milwaukee
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