Warning: this post contains the words yeast, breast, and nipple. Just as a disclaimer :D
I've been battling the yeast, as you all know. Here is what seems to be working for us:
First, initial treatment:
-gentian violet in baby's mouth and on mother's nipples, once a day for 7 days
-Jack Newman's APNO (get the recipe for Rx here), applied to nipples after each feed until mother has been pain free for 7 days
Then it came back.
-Now I'm on Fluconazole, 400 mg initial dose and 200 mg twice a day after that, for 14 days (we are on day 3). This is the $300 stuff.
-baby gets suspension of Fluconazole, 3 mgs/Kilo (initial double dose), for 14 days
-airing breasts as much as possible
-soaking breasts in apple cider vinegar (approx 1/2 cup) diluted in warm water (approx 2 L) daily for about 20 minutes
-pull open a gel capsule of probiotics (acidophilus and bifidus or whatever that second one is), mix with a few drops of water to create a paste, and apply to nipples with q tip. Don't wash off before next feeding, as baby's mouth and gut will benefit from probiotics and will also help clear up yeast infection of baby's mouth
-rub a small, pea sized amount of anti fungal cream (Myconazole is what I have--Nystatin is not recommended because most strains of yeast have developed a resistance to it) on nipples right before and right after each feed
-250 mg grapefruit seed extract orally, three to four times daily
-cut out refined sugar from diet
-stay away from hot tubs and baths
Here's hoping it goes away and STAYS away, this time...
I think the key may be this missing step I didn't have the first time around: boil all soothers (and/or bottle nipples etc) and breast pump daily for 20 minutes. I think what happened is that Riley's soothers re-infected us, so this is key. The reason I am being so aggressive with this is because I have had 4 years of chronic yeast infections so I know I am prone to them and have to be assertive to get rid of them. The last thing I want is a threat to our breastfeeding relationship...Riley's age is where breastfeeding gets less work and more enjoyable, so I was looking forward to things being easier, not more complicated!! Each month of breastfeeding (IME) gets easier and more enjoyable, and I always feel sort of bad for women who stop early because they toughed it out through the hard part and didn't get to reap the benefit of the more enjoyable part. The relaxed, cuddly part. Nutritional and immunological benefits do not disappear over time [most of you probably already know that, but I have had several women tell me that breastmilk has no nutrition after 6 months and that if you breastfeed longer than that, you are just doing it for yourself....fortunately they were relatives of Brent so I had emough social restraint not to pour forth diatribes or punch them....this was when Ayden was a baby], and the WHO, UNICEF, IBCLC board, and a bunch of other health and research minded groups who should really know best, recommend breastfeeding exclusively for 6 months and continuing until a minimum of 2 years of age.
The worldwide average age of weaning is 4 years old.
Breastfeeding toddlers is normal and beneficial and should be supported.
Humans at birth are the most immature of all mammals.
Based on surveys of lactation duration in mammals in the animal kingdom, humans 'should' breastfeed for an average of 7 years.