In a message dated 6/26/2003 10:28:35 AM Eastern Standard Time, [log in to unmask] writes:

> Problem - mother (of twins) has been
> battling a yeast infection for the past two months which has not
> only affected her breasts but babies mouths and diaper areas. She
> tried Nyastatin initially then changed to gentian violet. She 'phoned
> me two weeks ago telling me about this problem and we talked
> about using Diflucan...
> Now she has been on Diflucan 100mg. BID for two weeks.

It is not clear how the mother has gone about coordinating her treatment with that of babies... Have all three been undergoing treatment simultaneously? Have babies been treated freuently enough each day, since yeast apparently reproduces to original proportions within 3 hours? (Many pedi care providers may undertreat with such as nystatin and many mothers don't apply it appropriately.)


> She is concerned that she
> still has a touch of the yeast infection, is wondering if this means
> the end of breast feeding - very anxious to continue, I have
> encouraged her to continue the Diflucan. She said about two days
> ago both babies had white patches on their tongues - where is that
> from? She is boiling nipples, pacifiers etc.

From the lectures I've been to and the papers I've read, yeast is tenacious and can survive even an hour of boiling. Also, all that cleaning and boiling could possibly affect the integrity of the material the teats, pacies, etc. are made from. May be worth pitching and getting a new batch every so often when yeast is recurring.

> She feels the babies
> could have it "all the way through". Says Nystatin is useless and
> unwilling to over-use the gentian violet.

If in mouth and diaper area, it does appear to have traveled through GI tract. The nystatin may be useless because the rec may not be for often enough to make a real impact -- or babies' and mother's treatment may not have been coordinated in a way to avoid constant reinfection of one another. Not sure what she means by overuse of gentian violet...

If she hasn't already and if babies are willing, she may be able to limit reinfection somewhat by assigning each baby a breast until situation resolves.


> I had suggested originally
> she try Dr. Newman's All - Purpose Nipple Cream for sore nipples/
> candida - her pediatrician  - an an excellent pedi - refuses to
> consider this.

Since this cream is for nipples (not babies' mouths) and since this mother may very well have a bacterial infection superimposed on yeast infection -- and definitely has inflammation, it isn't clear why the pedi is commenting on its use. Would think she could pat off any excess prior to feeding, although excess shouldn't be an issue if used correctly.

Hope the above offers some ideas. Don't know why breastfeeding would "have to end" when mother (and babies!) wants to continue, but in my experience, coordinating mother's and babies' treatment and ensuring treatment is adequate/"strong" or frequent enough are key.

Good luck to you and the mom. I know from personal and other MOT/MOM experience how "unfun" yeast with x2(or more) babies can be.

Karen

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