For the record, I've been feeling much more even keel for the past few days. Even in the midst of chaos, I've felt much more in control and calm. So I'm very, very hopeful that the last couple weeks were just those pregnancy hormones leaving the premises. Peace out, you wacky hormones. Don't let the door hit you on the way out.
In other news, we are on Day 13 of DIE THRUSH DIE. Thrush not yet dead. [Insert huge, heaving sigh here.]
Since one of my greatest and worst attributes is tenaciousness in the face of an fact-needing situation [read: I'm obsessive in an annoying way sometimes], I am now something of an expert in thrush. I had plenty of middle-of-the-night feedings to research it, anyway.
This latest and greatest treatment is called Gentian Violet, which a few of you recommended. What you do is paint this weird purple dye on your nipples and then feed the baby. Makes total sense, right?
Immediately after a feeding:
It's OK to laugh at my baby. We do. After the feeding it fades to a sort of 5-o'clock shadow look.
5-o'clock shadow with accompanying purple lipstick, that is.
As for me, I feel very, very fancy having bright purple nipples. And I can only imagine that Oliver feels very, very fancy himself. It's so rock and roll.
It should be noted that I feel less fancy and more completely awk to go out in public with a purple baby.
This is going to sound weird, but I think the thrush issue triggered my PTSD from when we dealt with bedbugs five years ago. They are similar hard-to-cure and super labor-intensive problems and all that old bedbug stress came back when I learned about the thrush treatment protocol. The bedbug thing made me so crazy, because it's incredibly time-consuming and can be expensive and at the end of the day all your efforts might not be enough. And a lot of the exterminators, who
should be the experts, didn't have a clue how to effectively kill them. Bed bugs are one of the most persistent little f-ers out there. They can live WITHOUT FOOD for a year or longer. A YEAR. In the midst of bedbug-ageddon '06 I may have sought out the help of one of our nation's leading bed bug experts, especially since he lives right here in Minneapolis. I mean, really now. I did that. And he was awesome and I will love him forever and he was all, "Go have a glass of wine! You'll be fine". He was bed bug expert with a side of counselor, clearly.
Anyway, all this is to say that in my head, thrush is equal to the bed bug stuff. The people who should know what to do - pediatricians, midwives - seem confused and give treatment advice that is just plain wrong (i.e. put the nystatin suspension that contains SUGAR on your nipples to treat them, too...sugar is what yeast feeds on). As a dietitian I totally get not being able to know everything all the time. I remember a client came in and was like "I have Addison's disease, now what do I eat?" and I was all, "Uh...gonna have to get back to you on that one after a little research." You can't possibly know it all. And so I don't blame those medical professionals, but it's frustrating. But in the end they all seemed to believe that I knew my shit and were willing to write me prescriptions for gentian violet (which is technically over the counter, but proved very difficult to track down) and All Purpose Nipple Ointment. But I so had to go out of my comfort zone to insist that we step up the treatment.
Finally, for those who get their kicks out of knowing another's thrush protocol (all 2 of you), here is a summary of what we have been up to. Now I'm fighting this pretty aggressively, because I just want it gone and I'm aware of how persistent it can be. Info mostly gleaned from the
thrush resources on KellyMom that I've been obsessively reading in the middle of the night during feedings. And if you too, ever find yourself in the throes of thrushville, by all means EMAIL ME. I will commiserate beautifully. Same goes for bed bugs.
- Started with Nystatin Suspension for Oliver. Gave 50 ml by painting his mouth with a Q-tip following each feeding (8 times/day)
- I am taking a diflucan pill for two weeks (maybe more?) to kill the boob yeast.
- Wipe nipples with vinegar solution after each feeding (1 cup water with 1 Tbsp distilled white vinegar)
- Put ointment on nipples and let them hang free to the wind as much as possible (started with plain lotramin, moved to homemade all-purpose-nipple-ointment, now doing real APNO)
- Switched to the Gentian Violet for a few days in place of the Nystatin
- Eat a low sugar/low dairy diet. (They recommend a much more strict diet, but...no. Maybe it it becomes a recurring issue. And I've maybe had dessert the last couple days because I'm bad ass.)
- I attempted to take a lactobacillis supplement, but my stomach wanted no part of it as I'm already taking supplements for my anemia in addition to my normal pre-natal/vitamin D/omega-3s and my placenta pills.
- Wash hands obsessively - before and after feedings, before and after diaper changes, before and after giving Oliver's medication, before and after nipple treatment, and before and after me using the bathroom. Plus, you know regular hand washing. This is possibly the suckiest step as you will have to put that baby down a zillion times during the feeding/changing cycle.
- No diaper wipes so we wet baby washcloths at each changing.
- Sticking with disposable diapers as cloth can harbor yeast (sorry, Earth). Also, try to air out diaper area (um...impossible-like and messy) and use an anti-fungal ointment a few times a day.
- Use only paper towels rather than hand towels as yeast will live in towels (sorry again, Earth)
- Use disposable breast pads and change after every feeding (don't hate me, Earth!)
- Each burp cloth, towel, receiving blanket (or anything that gets milk on it) should be used only once. Insane amounts of laundry.
- Speaking of laundry - everything on a hot wash and then add a cup of vinegar to the rinse cycle. Dry on high heat or dry in the sun if possible.
- All pacifiers and pump parts need to be boiled and/or sterilized after each use
- Breastmilk cannot be stored or frozen. So I haven't bothered pumping yet. Very thankful I'm not in the position of needing to build up a supply.
Oh, and finally - you have to keep all this up for a week or two AFTER the symptoms are all gone. Should things continue to linger I will look into the grapefruit seed extract and
possibly diflucan for Oliver. Also? My head would likely explode if the thrush continues to linger.
Yeah, thrush sucks the big one. DIE THRUSH, DIE!