For a while now I've had a serious bee in my bonnet about thrush treatment. Thrush can be so painful, and so hard to get rid of. But worst of all, it seems to be the problem which elicits the worst advice and treatment.
Here's my list of myths around thrush and thrush treatment. Feel free to add your own in the comments section. And here is Dr. Jack Newman's Candida Protocol, a wonderful resource on thrush treatment.
1) There is a reliable test to diagnose thrush. There is no reliable test for thrush, so you have to go on difficult to detect detect things like the shininess of skin, the type of pain, the color of skin.
2) If the baby doesn't have yeast in the mouth, you don't have thrush. Lots of mothers are told this. Then they treat for thrush, and the symptoms go away.
3) All burning pain is thrush. Lots of women are treated repeatedly for thrush before discovering that they have Raynaud's Vasospsam of the Nipple. The pain with Raynaud's is similar to thrush, so they are confused often. La Leche League offers a list of other possible causes of pain here (scroll to the bottom).
4) Nystatin is a good anti-thrush medication. Nystatin is the medication most doctors prescribe, but it's effectiveness is pretty limited. When I heard Jack Newman speak last year he said that it works on about 30% of yeast. While it works sometimes, it often takes a full 10 day course to see a big improvement, and that's just torture for most mothers. See #5 for a much more effective treatment.
5) Gentian violet is a dangerous treatment. Gentian Violet got a bad name from a really bad study, and now doctors are reluctant to recommend it. However, the American Academy of Pediatrics' Breastfeeding Handbook for Physicians lists it as one of two recommended treatments. Yes, it is messy and gives your baby a bit of a goth look. And somehow thrush always knows to strike just before a big family gathering where lots of pictures are going to be taken. But it's very effective against thrush, and it's considered safe.
6) If you have deep breast pain with thrush, you should take a one day course of Diflucan. I've seen lots of women who have been diagnosed with yeast inside the breast (intraductal yeast). But they've been prescribed a one day course of Diflucan. This would be great for a vaginal yeast infection, but for intraductal yeast, they need a longer course, usually two weeks worth.
7) Treating only the mother, or only the baby, is effective. Some doctors won't treat both the mother and the baby, even though the yeast is being passed back and forth. This just makes the recovery take longer and prolongs the agony.
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