Hi Jaime,

I do not understand the constant instructions for this mom to stop breastfeeding, but if mom needs to temporarily 
pump and feed EBM for her own comfort, then that would certainly be a better option than weaning the baby. I also 
do not understand why she would be offering any AIM at all---nothing is going to improve for anyone by adding AIM
to the equation. If her supply is low, that can be addressed.

That said, I have worked with a number of moms with similar symptoms and these are things that have worked:

if yeast is indeed a part of the picture to such a degree, mom cannot "cut down" on sugary foods--she has to 
completely eliminate them. This includes the obvious sweets, but also includes fruit juices, many fruits, simple 
carbs,cow milk products (I never encourage yoghurt and do not think it ever helps--it is a mucous-forming food 
that weakens the immune system--that is not a benefit). Avoid anti-bacterial soaps and other similar products 
like hand sanitizers. Focus on greens, vegetables, proteins, low-sugar fruits, some whole grains. Avoid additives.

I once worked with a mom by phone who had been treated repeatedly with diflucan--I sent her to her OB to ask for
abx for a possible bacterial infection. I told mom to support her gut with probiotics and a yeast-type low sugar diet 
to avoid a new yeast infection. Months of symptoms finally resolved.

Another mom I worked with had a staph infection that had begun with a yeast infection. It resolved when her homeopath
treated for staph, in combination with colloidal silver topically. 

More than a few moms have had raging nipple thrush resolve only once their babies'  posterior tongue-ties were
clipped. I suggest you not overlook this possibility. Continued trauma will keep an infection going, no matter what 
treatment you use. 

Very few of my clients use nystatin or diflucan, b/c they don't work, are risky or unnecessary. Usually we get the 
best results by finding and eliminating any underlying structural causes, improving moms's diet, using galactogogues
if supply is suffering (which it often is when mom is in so much pain), using probiotics and possibly attending to 
mom's overall  health, since healthy people don't have a yeast overgrowth.

Finally has anyone considered having a dermatologist look at that rash?

Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC



"Baby was first diagnosed in November (at 1 month of age) with oral thrush by babies pediatrician, baby was 
given Nystatin.  Mom's doctor gave her Nystatin cream for nipples.  At that time, Mom had sore nipples but no 
thrush rash=No relief of symptoms for 6 or 7 weeks with use of Nystatin for Mom and baby had refilled prescription 
and continued to use this entire time.

In December, Mom saw babies doctor again, and baby was given diflucan and Mom was told to stop nursing.  Mom also 
contacted her ob-gyn at the time and her doctor didn't want to prescribe diflucan for her. This is when I was brought
in.  Mom called me, didn't want to stop breastfeeding and wondered what to do to treat the thrush.  I discussed
simultaneous treatment.  Mom called her doctor back and after trying a different Nystatin cream, was able to get a 
prescription for Diflucan (150mg/day 1 time a week for 2 weeks) from another doctor in the practice. Babies doctor 
also gave a prescription for Gentian Violet in December, babies symptoms have improved significantly with this.

Mom then visited her doctor in January (diagnosis for Mom had been over the phone because she has no insurance and 
can't pay for the doctor's visits) and was confirmed that Mom had thrush.  Her dose of diflucan at this time was 
increased to 150mg/day for 7 days.  No improvement of symptoms, so prescription changed to 100mg/day for 14 days.  
No improvement again.  Rash would worsen, then improve next day, then worsen- continued like this for the course of
treatment.Now, doctor will not see Mother or prescribe any more meds until mom stops breastfeeding.  She does not have
a primary care physician, so has been seeing her ob-gyn.  She does not want to stop nursing, but continues to be in a 
lot of pain.  Rash has worsened since diflucan treatment has stopped.

Some more pertinent details: Rash on Mom is red, scattered, patchy bumps.  Look like water filled sacs pustule, that 
are the size of a pin head.  Nipples are raw, open and visible bumps when baby comes off breast after a feeding.  
Between feeding, rash is dry and sore.  Rash is around and on nipples, areola, under and on sides of breast.  Not on 
the top of breast. Pain at nursing is described as "someone's fingers under my skin", very itchy and sucking feels 
like something is pulling and itching through the milk duct. Mom can feel the pain from the base of her breast and 
work it's way to the tip of her nipple with baby nursing. Mom has a vaginal yeast infection as well, which she has 
had since June/July.She is treating this with topical cream, over the counter.  Has not helped mom at all.  She was
also diagnosed as a child with "allergy to yeast".  She admits being a heavy alcohol user in college, with no yeast 
problems during this time. Mom is washing all clothes in vinegar. Has changed diet also- cut down on sugary foods, 
eats more whole grain, increased yogurt (eats 6lbs per week),more green vegetables, cut down on fatty foods.  Mom and 
Dad are also taking acidophilus capsules daily.  Dad shows no symptoms of thrush but has been taking the acidophilus 
and following the other dietary changes.Mom has started to introduce formula, but baby doesn't like it and doesn't 
want it.  Mom continues to breastfeed as long as she can tolerate the pain. She is also pumping 4-6 times a day, and
offering her milk in a bottle.












________________________


 


Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC

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