Wednesday, November 9, 2011

Yeastie Beasties

Candida A. is a nasty little fungal infection that likes to move in and take over, Unfortunately it makes breastfeeding very uncomfortable. We see lots of moms with sore nipples that can be attributed to a yeast infection. Sometimes the baby may have thrush in his mouth, but not always!

Symptoms

  • New nipple pain after pain-free nursing
  • Deep shooting breast pain. It may present as extremely painful let-down but will usually also occur 1/2 hour to 1 hour after nursing
  • Purplish-red color on the nipples OR shiny nipples OR whitish dry looking skin on nipples
  • White patches in baby's mouth that won't scrape off or an angry red bumpy diaper rash.

Diagnosis

If you're not sure whether you're dealing with thrush or not, but you have some (or all) of these symptoms, then see a lactation consultant or La Leche League leader. There is no diagnostic test. Sometimes a doctor may think everything looks normal (after all, aren't all nipples kind of pink?) However, when the mom is treated for thrush, the pain resolves! So if you have an International Board Certified Lactation  Consultant who can contact your doctor with her evaluation of your condition, that may help since IBCLC's are generally recognized as the true experts on all things related to breastfeeding.

Treatment
  • Dr. Jack Newman has a terrific protocol for the treatment of Candida. We have had great success with it when it is followed to the T!  
  • The first step is the APNO (All Purpose Nipple Ointment) available at local compounding pharmacies like Sterling Pharmacy, Madison Drugs or Huntsville Compounding Pharmacy. You have to have a prescription from your doctor. Ask that they compound it with Flucanazole instead of Micanazole. 
  • Several local pharmacies actually compound Lactation Consultant Nipple Ointment which is not quite prescription strength but still very effective. You will find it at Sure Save Pharmacy, at County Line and 72, Madison Drugs and Sterling Pharmacy.
  • Gentian Violet, is messy, but very effective. It is available locally in Huntsville at Madison Drugs, First Pharmacy or Sure Save at County Line and 72.  
  • Be sure to ask your baby's pediatrician to treat your baby with either oral Nystatin or oral Diflucan (preferred) if you don't use the Gentian Violet.
  • If you do end up needing Diflucan (Flucanazole) be certain that your doctor understands Dr. Newman's protocol. You need a 400 mg. loading dose and 100 mg. twice a day for at least 2 weeks or until you are symptom free for a week.
  • Be sure to keep your nipples dry. Bra pads with any plastic may aggravate the problem. If you use cloth pads, change them frequently. This is a good time to switch to a pad that wicks the moisture away from the breast.
  • Keep everything that comes in contact with baby's mouth clean - lots of moms actually boil pacifiers etc.
  • Wash bras and pads in hot water
  • If yeast persists, check out a Candida Diet.  Some mothers finally find relief when they take this step!
If you think you may have a problem with Yeastie Beasties, give us a call! We're the Yeastie Beastie Busters!

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