h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

You have supplied a very nice summary of a problem that is, for some mysterious reason, largely ignored by physicians. The only people who seem to know about it and diagnose it on a regular basis are lactation consultants. This problem needs much more airtime than it gets because it is SOOOOOOOOO painful, that it often results in women giving up breastfeeding within a week of childbirth, which has a significant effect on children's eventual outcome, as is now well recognized. Thanks alot.

Hello Tension_in_the_Galaxy,

Thanks for for the compliments! I held off from writing this entry for a long time because it's such a yuk subject, but I did feel strongly that we needed a comprehensive entry on thrush and how to deal with it. Anything to get rid of the thing as soon as possible, as you say it's flipping painful!

Have you had experience of it yourself or are you a lactation consultant?! When I heard that the hospital where I had Dominic had a lactation consultant, I laughed. How was there a need for a full time person to advise women on breastfeeding? Little did I know I'd be seeing her on such a regular basis. She was brilliant

I was going to ask too - how did you find h2g2?

Anna

Hehe.......you have the pleasure of talking to a bran-spanking newbie!!

I was just sent, from Canada, as a birthday gift, a copy of Salmon of Doubt.....and just finished reading it today. In there are multiple references to h2g2 and so here I promptly am as of just a few days ago.

The answer to your question is......yes, I had bitter experience with thrush myself at the beginning, almost quit, saw a lactation consultant who knew what it means when a patient says "it feels like someone's coming at me with razor blades", and fortunately am now still nursing almost 21 months later........and no, I am not a lactation consultant......I am a doctor (who didn't recognize it, eek!).

How long have you been coming to h2g2?

Hey there, Anna! Nice entry, I look forward to seeing it in PR soon.

You might consider adding something about "gentian violet" in the treatment section -- it's a huge pain in the neck to use, but very effective, safe, and recommended by a lot of pediatricians and lactaction consultants...

Here's a few links on the topic:

http://www.bflrc.com/newman/breastfeeding/gentviol.htm
http://www.icgold.net/mother/thrush.html
http://www.parentingweb.com/lounge/newman/nm_gentian.htm


Mikey

Dear Tension_in_the_Galaxy,

'It feels like someone's coming at me with razor blades' is a good description. My personal one is it feels like jump lead clips are clamped to your nips. Owwww! Interesting that the condition isn't widely known among doctors. I had a few GPs sitting in with my lactation consultant when I went to see her.

Well done to you for breastfeeding still. I managed about three weeks being completely problem free and then I'm afraid I gave up after a bout of mastitis. Too bad really - but I breastfed for about six months, which isn't too bad.

I've been at h2g2 for just over three years. In actual fact I work for the site, dealing with volunteers mainly and editing and so forth. In essence I have quite a lot to do with the Edited Guide, so if you've got any questions about writing entries, let me know

If you're looking about for things to do on h2g2 PeerReview is a good place to start and there are often several medical entries in there that could use your expertise if you'd care to contribute it. <./>Askh2g2</.> is another good place to go, and if you're after something topical there's the h2g2 parent and baby group. We're over at A265169

Welcome to h2g2

Anna

Hello Mikey

The entry's already in the Edited Guide! I can update the entry and when I was writing it I considered putting something in about gentian violet, but I haven't used it myself and wasn't sure that it was recommended by health practitioners, and so was reluctant to put it in. Do you know anything about it?



Anna

Thanks muchly Anna.......will fish around for a bit and see what there is to see. Just getting my feet wet really, for a bit.

By the way.....gentian violet does work but it is considered a bit archaic now since the antifungal ointments are mostly harmless (hehe). Plus, it really is a pain....it stains the skin purple (maybe that's a bonus if hubby likes it, but otherwise.... ), and some babies are a bit particular about purple food containers, so to speak. I imagine it doesn't taste too great either. And myconazole or other anti-fungal ointments are pretty harmless....just a quick wipe before nursing in case of taste sensations, and you're all set. They don't get into the milk, as far as I know.

Thanks for that. I'll add something in about gentian violet So what are your areas of medical speciality then?



Anna

Hi Anna:

Um, I have a few specialties, actually. My first is general pediatrics, but I went on from there into pediatric intensive care, and also adolescent medicine, and also into high-altitude transport of the critically ill. Got a little sports medicine thrown in for good measure too, hehe.

So it's particularly ironic that, as a professor of pediatrics, I didn't recognize the thrush when it hit me. I had had a complicated C-section and had been on antibiotics, so the evidence was staring me in the face, or the mirror anyway......and as soon as the lactation consultant said it......I almost blurted out, Oh my God, how stupid of me not to realize!!

Wow, you'd be a handy person to have around. (How on earth did you get into high-altitude transport of the critically ill?) I always do that classic parent thing - if Dominic even seems the slightest bit unwell, I immediately think it's something awful and when he's asleep I go poke him to see if he's still breathing. I thought I'd grow out of that after the first six months, but no... Having said that, I've got a friend who's a pediatric nurse and she's even worse than me!

I don't think it's that surprising that you didn't spot it. I believe there hasn't been much research on it? And the evidence is ancedotal? Though my lactation consultant (at St George's in Tooting) was trying to get some funding for research through the Department of Health. Hope she did

Anna

Dear Anna:

Yeah, I found it surprising that I didn't spot it because I know I should have known better, research notwithstanding.......yeast colonizes everything and after antibiotics, everyone. Even though the condition hadn't been well investigated or published, it should make intuitive sense to anyone used to the behaviour of yeast (a major opportunist if ever there was one) in an antibiotic environment. Oh well, what's life if not to live and learn, right?

The transport is part and parcel of working in intensive care units for children.....since there aren't too many of them, but kids get sick everywhere.....so there had to develop a service for transporting them to facilities capable of taking care of the very sick.

By the way.....no one is free from the night watch....I, too, have been known to go in to confirm that she's breathing....the only advantage is that I don't have to poke her....I can just stare at her chest like I have a fixation, just waiting for the telltale movement which will give away the fact that all is indeed well, hehe. Of course, I am in denial about it most of the time.....I call it "blanket rounds".....and fool nobody but myself, of coure.

Hey Tension in the Galaxy,

Sorry I haven't got back to you sooner. I was away on Monday and some of my messages slipped down off the bottom of the page. Dominic wasn't well with a cold - not ill exactly, but he hadn't eaten his breakfast, which is unheard of for him!