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Subject:
From:
Fiona Coombes <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 26 Apr 1995 12:25:00 GMT
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 However, most of the mothers I see with suspected yeast end up on oral
Diflucan.

This is interesting to hear as I have only been game enough to treat mothers
with oral nystatin. I know that it doesn't appear in breastmilk, and the
reason it works seems to be related to reducing the overall colonisation
of the mother's body by thrush, rather than a direct effect on the breast.
I also use a topical treatment for both nipples and baby's mouth (usually
miconazole gel), plus treatment of nappy (diaper) rash and vaginal thrush
if indicated.
I have thought of using oral fluconazole, but have been put off by the fact
that it appears in breastmilk at concentrations similar to blood levels,
and can cause abnormalities in liver function tests. The manufacturers
do not recommend its use in lactating women.
In Australia it can only be prescribed either as a once-only dose of 150mg
for recurrent vaginal candidiasis, or as a longer treatment for life
threatening fungal diseases. The cost of any more than the once-only
 treatment is extreme (more than A$200 I think). Ketoconazole tablets can
also cause liver enzyme problems, and again, I'm not sure about using this.
 I've never considered oral Terbinafine, as it is only active against
candida in the ointment rather than tablet form, according to the information from the
pharmaceutical company.
I'd be really interested to hear about other drug treatment for thrush, as
experience in my part of the world seems limited. What has worked for you?
How safe was it?

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