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Plugged duct OR... evil yeast? LONG!

post #1 of 17
Thread Starter 
My ds (born 2-15-00) and I struggled with yeast several times while he was just a few weeks old. We boiled everything, tried nystatin, he had a reaction (I can't remember exactly what it was, what a bad mommy, I think it was a rash?), stopped nystatin. I took Diflucan, used Monistat on my nipples (which really freaked me out!), tossed the disposable breast pads (what a joke they are) etc. Our symptoms at that time were white patches in his mouth, white flaky patches on my mipples (though those were never that noticeable), pink nipples (they're usually brown), a wicked diaper rash, and PAIN! I had the "icepick" variety of pain between feedings and in the first few minutes of feeding.
I never felt like I really licked the yeast - and always wondered about it. Continued to have itchy or sore nipples on and off since then but I've put it off to bras that rub.

Now, fast forward to October, when I've been struggling with what everyone says is a plugged duct. Lump in the breast, gets softer with compresses and focused nursing for a couple days, very sore, but the lump never completely goes away. I first noticed this as a weird spot like a pimple on my nipple, right at one of the nipple openings. NO milk was coming out in that spot. Went to my OB, she said it's not a breast infection, the breast is not red and hot, check with the LC. I trot downstairs to talk to the LC ("Hi. Would you look at my boob?") I tell her about how it's been like this for two months now (I finally went to her around the beg. of Dec.) and that it's not like the plugged duct that my friend described (she said hers was like a plug of fat that eventually came out the end of her nipple). Mine is like this - after my little ritual of soaking in warm water, massage, then pumping, milk does come out of the nipple opening in question, but the edges of the opening are white and puffy. LC says yes it's a plugged duct, but of course I can't show her how it looks after I pump...I've also noticed a drastic reduction in the milk that I can pump from this breast (like cut in half!).
This is what I've tried - adjusting my seatbelt, pitching any uncomfortable bras, soaking and ginger and warm water compresses before pumping and nursing, lecithin (recommended by the LC to break up the fat), hot showers before and cold compresses after nursing (recommended by my LLLL). Also fenugreek and drinking lots of water to try to combat the decrease in supply - thinking that I could flush it out...

This is my question - since my nipple doesn't look like what I've heard described as a plugged duct, and hasn't changed drastically in over three months with treatment, is it possible that I've actually got a deep yeast infection? How would I know? There's no "icepick" pain, but there are some very serious twinges randomly through the day. My nipples are still very pink and always sore. HELP!
post #2 of 17

The YEAST monster and how to tame it

It sounds like you have a long-term, unresolved yeast infection. Yeast can cause plugged ducts and a decrease in your milk supply, just like you're describing. For more details about yeast, check out the article on my website all about yeast, signs and symptoms, and treatment plan.
Please don't give up! After battling yeast for this long, you are definitely a veteran, and you deserve to enjoy nursing your baby without pain. It can happen if you hang in there and get the appropriate treatment.
You've tried the conventional treatments, and they haven't worked, so now it's time to bring out the big guns and clear this up once and for all. I don't know how long you were on the Diflucan, but it is common for doctors to give you a few tablets, but that's not enough to really clear up yeast that's taken hold the way yours has.
Diflucan is a systemic antifungal agent that was developed in response to the other agents (like nystatin) not being as effective against yeast anymore, just like new antibiotics are developed all the time in response to resistant strains of bacteria. It has been around for many years, but until the last few years it was mostly used for AIDS and cancer patients because their strains of yeast were more virulent and their immune systems more compromised. A few years ago, it was introduced as a popular one dose treatment for vaginal yeast infections, and was widely advertised in all the women's magazines. At around the same time, the problem of intra-ductal yeast became widespread and lactation consultants discovered that Diflucan worked in treating this incredibly painful condition, but only if taken for much longer (up to a month) than the one dose treatment for vaginal yeast. Over the past few years, there have been many many cases of intra-ductal yeast treated successfully with Diflucan, and their have been very few side effects. In 1995 (I think that's when it was, but don't quote me on that) Diflucan was approved for use in pediatric patients with oral thrush. Dr. Hale states that 90% of pediatricians use it now because thrush is becoming so resistant to other anti-fungals like nystatin.
The thing is, unlike many other medical conditions that can be treated successfully by a variety of drugs, intra-ductal yeast seems to respond well only to diflucan. There aren't a wide range of treatment options like there are with yeast on your nipples. You pretty much go with the diflucan and clear it up, or you suffer for months and months. That's one reason that I get on my soapbox and try to teach mothers to identify the early symptoms of topical yeast, so that they can nip it in the bud before it gets into the ducts where it is so difficult to treat and so incredibly painful.
The difficulty is in #1, convincing your doctor to treat both you and your baby, even if your baby has no visible symptoms; #2, getting your doctor to prescribe diflucan;and #3, getting him to give you at least 2-3 weeks of daily treatment.
I would try to find a supportive doctor. Ask local La Leche League Leader or Lactation Consultants for the names of 'breastfeeding friendly' doctors in your area. Offer to share Dr. Hales info with your doctor. If he doesn't have the book "Medications and Mother's Milk" and can't find a copy of it, have him go to Dr. Hale's website: http://neonatal.ttuhsc.edu/lact. Most doctors will give you the diflucan you need if you explain to them that you have tried everything else first, and if you provide them with written references that testify to it's effectiveness and its safety. Doctors love to see stuff in writing, because then they have someone else to blame if something goes wrong.
I hope this helps. I know how frustrating this whole yeast thing can be, but there is light at the end of the tunnel - I promise. You have many months or years of pain free nursing to look forward to, and you've come too far to give up now. Be strong, and insist on getting the treatment you need.
Let me know if I can help in any way. I wish you all the best, and I hope that you'll let me know how it all turns out.
post #3 of 17
Thread Starter 
Oh, thank you thank you thank you! This whole time I've been convinced that I was just not doing the right thing to clear the plugged duct. I am so grateful for your response! I'm going to call the OB right now!!! Thanks again - and wish me luck!
post #4 of 17

Anne, this what I'm dealing with too!

Anne, this is Paula again. It seems that I am dealing with this same problem . I am printing this to take to my Dr in hopes that he will just give me the medication.

Thanks, Paula

P.s Went to the DR yesterday 1/16/01, the Dr is treateing Nathan and I with the Diflucan (SP), started it today. He said that I was the first to bring this to him, I printed this artical and took it, he says thanks too.

[Edited by mom2nathan on 01-17-2001 at 04:25 PM]
post #5 of 17
I'm on this rollercoaster too. What's more, after talking (finally) to my LC, I think my daughter probably has it in her GI tract and that the yeast has caused her gassiness and discomfort and not "colic." Started Diflucan today 1/20/01 (both of us). Hoping for some big changes soon!
Belinda
post #6 of 17

HOW IS THE DIFLUCAN WORKING FOR YOU?

WE SEEM TO BE DOING OK. NATHAN CAN'T STAND THE TASTE....

I GOT ANOTHER BLISTER ON ANOTHER DUCK SAME BREAST. UNSURE WHY... TWO MORE WEEKS TO GO, PLEASE LET THIS WORK.....

GOODLUCK, PAULA
post #7 of 17
Thread Starter 
After 11 days of Diflucan, we seemed great. Though, it made RJ's poop look like oatmeal and smell awful! I took the last dose on Sunday - and I'm in agony with symptoms of a vaginal yeast infection today. I need to call the doc back - wonder if I have to start over again...ugh.
post #8 of 17
Thread Starter 
Oops, forgot to say that while on the Diflucan, I noticed no trouble with the nipple opening. But yesterday and today, it's been white and I've had to really work with pumping and massage to get any milk to flow from that spot.
post #9 of 17
i wanted to add that nathan has a small rash in his chin, and my face feels windburn and ichy. we go to the dr this morning to check it all out. hope it is nothing, tired of the yeast monster taking control of my normal breastfeeding relaxation.... keep posting on how you are doing.

paula and nathan
post #10 of 17
We've been on Diflucan for 6 days now, and I'm feeling better. I still have a lot of pain after I pump or nurse. Annie's gassiness is diminishing, but still there. We will be on it for a total of 14 days. How long are y'all prescribed for? I read one article abstract describing a woman being treated for a full month.
Belinda
Colby 6/25/92
Joshua 12/21/97
Annalise 8/15/00
post #11 of 17
We were on it for one week. Went to the DR yesterday, our rash wasn't caused by the medication. Thank goodness. Thought I told the DR that I might be pregnant, he took us off of it until we find out. AF is due Feb 4th, we'll keep all of you posted....

The medication was to be for 21 days.
post #12 of 17
Oh, my. I can't even imagine. Good luck with everything. How old is your baby? I haven't even had time to *risk* getting pregnant, which I guess is why I can't imagine
Belinda
post #13 of 17
hello to all. no we aren't expecting. though this ugly yeast monster still is lurking... back on the diflucan, and other home remedys as well. we are really going after him this time, i hate having this yeaster.....

My baby is 25 months.

I was given an artical regarding thrush is any one is interested, i found it quite interesting....

i will make copies if anyone is interested...

paula
post #14 of 17
I fought thrush with my first baby for months and finally quit breastfeeding because it would never really go away. Now I have a yeast rash all over my chest, underarms, etc that I got while on antibiotics. I have been fighting with it for almost two months now. I am worried that if I dont get rid of it soon before baby is born that I will go through the thrush thing again. I have already gone through three tubes of cream and they dont really help. Can diflucan be used to treat my problem too? If not what can I do?
post #15 of 17

Yeast during pregnancy

Hi Elaine,
Unfortunately, lots of moms give up on nursing because of the pain of yeast. It is rarely necessary to wean, because if the yeast is treated agressively and effectively enough, it can almost always be cured. The problem is that very few doctors are familiar with how to treat it, especially during pregnancy and lactation.
There are different strains of yeast just as there are different strains of bacteria. That's why if you are taking an antibiotic and the infection isn't responding within a few days, your doctor will probably try another drug rather than refilling the same one over and over again.
If you are using an antifungal cream and it doesn't work within a few days, then you need to try something else untill you find one that works. Have you tried Nizoral? It's prescription, and seems to work better than some others.
You're right to be concerned about yeast and the new baby. Once you have it, it can be awfully hard to get rid of completely, and chances are good that if you still have it when your baby is born, he will get it too. You probably never have gotten totally rid of it to begin with, and it just flares up more sometimes than others.
It is generally not recommended that you take Diflucan when you are pregnant, especially in the first trimester. I do know some doctors who have prescribed it in small doses during the last few months, but if your infection is topical and not systemic, I would try to treat it with cream instead. You can take acidophilus too, and that might help.
Experiment with different creams, but if they don't seem to be working, then I would see a dermatologist who has experience in treating yeast. They would probably be able to help you more than your OB at this point.
Good luck!
post #16 of 17
Dear Anne:
I have been on Diflucan, along with my daughter, for a total of 18 days this time (and finished my prescription). My baby is doing SO much better - has suddenly started sleeping through the night and rarely has the painful gas that had plagued her almost since birth. My question is this: Once in a while, especially after pumping, I get that pain in my breasts still. Though it is MUCH better, it's still there. Should I call my ObGyn and get a refill, or should the yeast be gone?? Don't want to wait too long and have it increase??

Belinda
post #17 of 17

Is the yeast gone?

Hi Belinda,
I'm so glad that the Diflucan has helped. It can do amazing things sometimes, but the key is to take enough of it to get rid of the yeast completely.
It sounds like you still have some yeast lurking deep inside your breast tissue. Since it's an intermittent problem, you can either wait to see if it goes away, or call your doctor and see if he would continue to treat you for a while. Some moms need to take the Diflucan for a month or more, and some taper off: they go from once a day to once every other day, then every third day, then once a week, etc. Sometimes you have to go back to once a day, then try tapering off again. You would have to work with your doctor on that.
I would lean toward going back on the Diflucan for a while longer, since it worked so well for you in treating the baby and the major symptoms you had. You don't want to ignore the pain and start the whole thing all over again, so if you do decide to wait and see what happens, or if your doctor doesn't want to give you anymore at this point, I would watch very carefully for any signs that the pain is getting worse or occuring more often. I would be very agressive about treatment if things seem to be getting worse instead of better.
Good luck,

Anne
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