is it teeth or thrush (again)?

[marimul77]

Hi everyone,

i am so sad  . The pain I am in when feeding DD2 is so nasty it makes me want to scream. It started about 6 weeks ago, as a kind of tingling sensation whenever she fed. I went to the GP and took fluconazole and DD2 got nystatin. I finished the course and things got back to normal. But about two weeks ago DD2 cut her top teeth and things have gone from bad to worse. How do I know whether the pain I am feeling is due to her teeth scraping my nipple or whether its another bout of thrush, worse than last time? It is painful from the moment she latches but as the milk lets down and she starts to take bigger gulps it becomes plain unbearable. I have not had any pain at all except the first few days after she was born and the whole thing is really upsetting me. She has had a bottle of formula this evening as I have no EBM stored, but I will try and express, just wondering if that will be painful too? If its not, can I assume its her teeth doing the damage? My nipples are sore even when I gently rub across them. I will try to get a GP appointment for monday but thought I would see if anyone had any other ideas?

Thanks!

[Erin (redstarfalling)]

Eek.  Sounds like thrush to me...

When a baby is teething and nursing, there can be some initial discomfort or even pain when latching or when they get bored, but if the latch is good, it shouldn't hurt at all when she nurses.  Remember that in a good latch, the nipple floats free in the mouth - the teeth don't connect with anything - or if they do, it can be part of the areola or breast with the top teeth a bit - the tongue protects on the bottom. 

Where exactly is the pain?  Is it in the nipple?

[Jocasta]

It sounds like thrush to me too :-/  What dose of fluconazole were you on?

Other ways to combat thrush (and you need to do all or as many of them as possible)


Lactose acidophilus capsules (you can buy these at local health food stores) - make sure you are taking AT LEAST 10 billion cultures per day - (a much higher dosage than is recommended - it's very difficult to overdose on the stuff so don't worry about exceeding the pot's dosage recommendations)

Grapefruit Seed Extract.  I couldn't get this at my local healthfood store but you can buy it on line if you experience similar problems in getting hold of it.

Make sure that anything that goes in baby's mouth is sterilized daily.

Make sure that baby's bedding and your bras are cleaned daily in a hot wash with a vinegar rinse.

Try and elimiate yeast from your diet - bread, beer, marmite etc. 

As far as fluconazole goes, you should be given 200mg twice a day for the first day, and then 100mg twice a day every day until at least a week after symptoms desist.  My GP didn't prescribe a strong enough dose and as such the thrush became resisten to fluconazole and I was suffering for months.  I think it was the higher dose acidophilus and GSE that finally kicked it's butt!  Anything that you do that works needs to be kept up until a week after symptoms desist to ensure that the thrush really has gone.

[marimul77]

I am thinking the pain is actually not in the nipple itself but coming from the areola. I can see indentations where her top teeth have been and they scab over a bit. The strange thing is that I have very little or no pain when I feed in the football hold position. Does that mean it is probably to do with the latch rather than thrush? If so, how did that happen as I have fed her for ten months in the cradle hold without any pain at all. I will obviously continue to feed her in the football hold as that is going ok but I dont know how to make her latch on in the cradle hold without any pain. She opens her mouth very wide and I have gone back to basics but it seems to make no difference? Thanks for your help!

[Jocasta]

Position wouldn't make a difference to thrush pain so yes, I think it is more likely that it's due to teeth.  I'd stick with the football hold for a while if that is more comfortable.  If you are 100% certain that it's not thrush, then lansinoh (or another brand of pure lanolin) could work wonders on the affected area if the skin is broken.  Don't apply lanolin if you suspect thrush though as it would provide the perfect breeding ground for the candida infection.

I'm the sort of person who learns best with experience and I've not yet nursed a child with teeth so I'm not really much help.  I'll do some thinking and get back to you if anything springs to mind

[Erin (redstarfalling)]

Babies often change their latch when they're teething and as they get used to the feel of teeth.  There's a FAQ on teething and how it changes things, if you want to check it out.  With teeth, you sort of have to start from scratch again, meaning every time you feel her using the teeth, you have to break the latch and start over.  She's now at the age where she can understand better, so you can also reinforce it with "no teeth".  Some positions are more comfortable for sure, so do that until you heal - but remember than any breaks in the skin can make thrush more likely, so keep an eye on it...

It's very possible to nurse comfortably with a mouth full of teeth!  My lo was 2 when she stopped nursing, but I remember we had some adjusting for a while when they first came in.