>baby is miserable; fussy during feeds at 2nd
>breast, fussy, gassy, colicky after feeds.

Can be either (or both) yeast overgrowth or food sensitivity.

>I can't remember everything as I don't have chart here at home.  My
>differential diagnoses are:
>1. milk allergy -- recommended dairy free x 21 days and gave lots of info
>on this

>Mom feels rt side is fuller but does
>not notice any forceful letdowns, etc.   Nipples misshapen after feeds
with diagonal stripe (uses cradle
>hold). Deep latch, no tongue tie, somewhat "chewing" motion with digital
>exam.
>3. persistant thrush
>4. combination of any and all above.

Laurie, it sounds like a combination of dairy sensitivity and yeast
overgrowth to me. I don't see much indication of oversupply. Of course,
"finish first side" is a good idea anyway.

The "cut" on the nipple sounds very "yeasty", as does the breast fullness
without a seeming oversupply.  The yeasty breast often feels full after
feeds and, as one mother said, "I feel a heaviness in that breast." As soon
as the treatment begins to be effective, the heaviness is gone and milk
flows easily again.

Babies with thrush will often use mom's nipple to scratch an itchy palate,
causing the compression of the nipple. And babies can be harboring oral
yeast without the obvious signs on cheeks.  I believe that a white tongue
is a sign of thrush, albeit sometimes without a problem to mother or baby.
But when mom has symptoms of yeast overgrowth and baby has a white tongue,
I call it thrush.  It does go away with antifungal treatment. The tongue
returns to pink from the front to the back, with the very back, near the
throat, being the last to lose the white coating.

You could talk with her at length about what to eat instead of dairy.
(Sounds as if you have already done that.) Even her addiction to it (over
use) is an indication of allergy, and with the over-consumption of it
during the pregnancy, the baby is set to have allergy too.  In cases like
this, there are often some withdrawal symptoms the first week. The mothers
are angry and depressed as well as agitated. I tell them that they may feel
this way and that they need to get foods into the house that are a real
treat to them. They need to pamper themselves in any way they can while
adjusting to the elimination diet.

One of the problems of treating dairy sensitivity along with yeast (which I
believe are related) is that to these moms all of the "comfort foods" are
dairy and sugar, both of which are favorite foods of the yeast also. Then
you add the emotional and physical drain that yeast overgrowth puts on the
woman, and you have a most frustrated, deprived person, often one who is
angry at the LC (Kill the messenger).

I spend a lot of time with these women talking about foods that they like.
They are surprised to remember some favorite foods that aren't disallowed
when treating for yeast.  Sometimes they are even reluctant to name them,
because they have just declared that there is "nothing" to eat if they
can't have dairy and sugar. As soon as they begin feeling better, with the
help of the anti-fungal, they are able to "like" more foods. (They even
like the LC better.)

One food that I have to tell them is ok is mayonnaise.  Many people think
that mayo is a dairy food.  I guess because it is white. Of course, I'm
hoping that there isn't also an egg allergy too.

I am amazed at the poor dietary practices of many of the women whom I work
with.  It is no wonder that they succomb to yeast overgrowth.  They eat
very little that supports a healthy immune system. They eat a heavy diet of
dairy, sweet baked dessert foods, chips, white breads, and very few (or no)
vegetables or fruit. Sometimes not even much meat, even though they aren't
educated vegetarians. Their only steady protein food is peanut butter,
which can be a problem in itself. This in not mature, healthy dietary choice.

And they don't eat any garlic!

I did work with a vegetarian last week with a yeast overgrowth. It is hard
for her to find adequate protein without the dairy, but she is
knowledgeable about foods and has done fine. She plans to decrease her
dependency on dairy in the future as an improvement in her overall diet. It
would be good for your client to cut down on her dairy foods too.  I
recently read that overconsumption of dairy is strongly related to yeast
infections.

Sometimes I understand why physicians don't want to diagnose and treat
yeast infections. Can you imagine many of them taking the time to guide a
mother through this jungle of allergy, poor diet, and yeast?

Patricia Gima, IBCLC
Milwaukee
mailto:[log in to unmask]