Seven myths about thrush.

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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Comments

[Rosemary]

#5 - gentian violet - isn't it a petroleum derivative? or in a petroleum base? do you have more information about this? i know it's quite effective, but if a mom is looking for a natural treatment, she may want to try other things first.

#7 - treating only the mother or baby - i think of yeast infections of all sorts as an imbalance in the naturally occurring bacteria and yeast cultures in your body. if this is so, how can it be passed back and forth? or can a person be in a state where they don't have the imbalance but are very vulnerable to being tipped into it if they get regularly exposed to a lot of yeast?

and... what about the idea that "thrush" may really be a staph infection in many cases? and gentian violet is effective against staph!

[Twinzplus3]

What an excellent post!

[Maya]

Thanks for writing on this topic. Last year, my baby and I struggled with thrush for about a month. The PA at our family practitioner's office would only treat me, and then only with Nystatin after I requested Jack Newman's All Purpose Nipple Ointment. Of course, this was ineffective. The lactation consultant who lead my breastfeeding support group suggested I try gentian violet and it worked like a charm. Since then, I've suggested it to other mothers dealing with thrush.

After doing some research last year, I also found that a solution of water and white vinegar in equal parts swabbed on my nipples after a feeding helped relieve the burning sensation.

[tanya@motherwearblog]

Hi Rosemary,

Here's Dr. Jack Newman on the base for Gentian Violet:

"Gentian violet comes as a 1% solution in water. It is also usually dissolved in 10% alcohol, as gentian violet is not soluble in pure water. This amount of alcohol is negligible, as the baby will only get a drop of gentian violet. Apparently some pharmacists will dissolve it in glycerine instead of alcohol, if you wish."

So the base is either water or glycerin (a petroleum product).

As far as natural treatments go, another alternative is Grapefruit Seed (not grape seed) Extract, and that's discussed on Jack Newman's Candida Protocol, which I linked to in the post.

I think the other thing to remember is that in most cases we're talking about pretty limited exposure. Jack Newman recommends using it once a day for 4 to 7 days, so the exposure is very small. You can compare that to Nystatin use, which is often used over a longer period, and applied more frequently (with limited success). Jack Newman estimates that "About 10 ml (two teaspoons) of gentian violet is *more than enough* for an entire treatment." Of course it's so messy that it probably looks like a lot more!

As far as passing it back and forth, if a mother has yeast on her breast and the baby is nursing, it can get passed back and forth through contact between the breast and the baby's mouth.

Yes, there is increasing thought that what we've thought is thrush is actually staph, or that they are both present. That's why some doctors recommend using an "all purpose nipple ointment" which is both antifungal and antibacterial.

Hope that answers your questions!

- Tanya

[lorraine]

The best and safest treatment for thrush that I have tried is a dilute vinegar solution (one tsp. white vinegar per one cup warm water) gently dabbed on my nipples after every feeding to clean them and then a warm water rinse. I also took acidophilus twice daily to increase my "good bacteria."