Thrush - does it turn babies into piranhas?

[allejane]

I hope someone will be able to help with this - it's becoming very frustrating and I can't get onto my LC til Monday! DD is 6 weeks old, and had oral thrush at 3 weeks which cleared up pretty quickly with Daktarin gel. I didn't notice any behavioural issues at the time and although I was also treating my nipples, I didn't have any symptoms.

Yesterday, I had excruciatingly sore nipples which looked red and shiny, which I put down to the fact that we're still learning to attach and feed without a nipple shield (day 10 shield-free, yay!) and my nipples are still a wee bit too big for poor DD to handle. However, DD today has a lovely white coating on her tongue. I then realised that my pain was from thrush so got onto the Daktarin for both of us right away.

My issue is - since 10pm last night, DD had been awful to feed. She is only opening her mouth a little bit (wide enough to fit the nipple & a bit of areola, but not enough for a good latch) and cries and screams when I get her into my arms ready to feed. Obviously I can't get her to latch like that - her arms go wild, her mouth is grabby and not wide enough, and I end up having to hand her to DH to calm whilst I get myself together. It's like trying to breastfeed a piranha. Last night (4am, eek) it took nearly 2 hours to get her calm and attached, by which time she was too tired to feed effectively.

Today I have been expressing so have bottle-fed her EBM and put her on the breast once she's calm. She is a little better at attaching then but it's still not perfect, and I'm worried that I may damage my already traumatised nipples.

Would oral thrush cause DD to have these sorts of issues with attaching? It's probably worth mentioning that she has silent reflux and has been on Losec for 6 days now (appears to be working) and also has awful trouble with wind pain (which I know can cause fussiness at the breast, but I thought only once she was on and sucking).

Hopefully there is someone here who has experienced this before - I am a bit worried that if it's not thrush, then what on earth is causing this behaviour?! Thanks for your help!

[Kmn]

oral thrush can make it hurt to suck, leading to very frustrated and confused babies. Mums who are expecting feeding to hurt can tense up which means that milk can take longer to flow - also leading to piranha like baby. Gently hand expressing so that you have milk flowing before trying to attach bub can help there.

It should clear up pretty quickly though - you are doing all the right things.

You also need to sterilise the expressing equipment and teats each time (which is not normally required) to make sure that you're not reinfecting yourself.

The ABA may have more suggestions - their number is 1800mum2mum

[Nelle]

Much sympathy, bub and I had thrush at 6 weeks too - just when things are supposed to be getting easier! I vaguely recall...is a bit of sunlight on the nipple supposed to help? And keeping the nipple nice and dry - I used lansinoh as a barrier I think. Since thrush is bacterial, so likes moist and warm conditions. I agree that relaxing is hard though. xo

[MantaRay]

It's really hard when they get upset at the breast It sounds like you have some great ideas you are trying there.

It could be the thrush, or some other pain that is worse in the breastfeeding position. Sometimes babies have something out of alignment from birth and that can cause that behaviour, or maybe a sore throat or ear. Especially if it happens more on one side than the other. Sometimes changing the feeding position can help - if you generally use the cradle hold you could try the football hold, side-lying position or even trying to hold her more upright rather than horizontal.

Six weeks is also a common "wonder week" - a time where babies feed more often than usual as their brains need fuel for periods of rapid development. It might be that she is too hungry by the time she is going to the breast. If this is the case, offering her the breast earlier might help - this might mean waking her earlier, or if she is awake, looking for the early hunger cues like opening her mouth, turning her head, sucking her fist etc. It can be really hard to spot these at first but you soon get to know them. How often is she feeding at the moment?

Another idea is to try baby led attachment. This can work really well when babies aren't opening their mouths enough. To try this you could sit in a reclined position, skin to skin at first works best but you can wear a top that doesn't get in the way if you prefer. When she is calm, place your DD on your chest between your breasts and gently support her. When she is ready she will either bob or lunge to one side, play with the breast, find the nipple and try to attach herself. Most of the time babies are able to do this with little or no intervention and usually when they are able to follow their own instincts the attachment is better than with mother-led methods. There is a good article on this here - Australian Breastfeeding Association - Baby-led attachment and a great little clip where you can watch it here - Biological Nurturing sample scenario.

All the best hun - as they say, this too shall pass

[allejane]

Thank you all so much for your replies, and sorry for not getting back to you earlier. Things have improved here - the thrush is gone (although I'm still treating both DD and I twice a day for another day or two just to make sure it's really gone) and she is now attaching a lot better.

kmn - thank you for confirming my suspicions that thrush can make it painful for the poor thing to suck - and I was definitely tensing up before a feed, I would nearly be crying when I saw she was waking up for a feed as I knew the amount of pain I would soon be facing! Thank you also for the hint about sterilising, I hadn't thought of that so got onto it right away. I usually sterilise twice a day if I'm expressing but ensured that I sterilised after every feed and I think that definitely helped to clear it up pretty quickly as I wasn't re-infecting either of us.

Nelle - yes, I was hoping that 6 weeks would be our turnaround point but it was rather the opposite! Getting sunlight on the girls is a little tricky - we are living next door to a house being built and there are tradies there from 7am til late afternoon, I did think about how to sun myself without giving them an eyeful but didn't have any great ideas. Will do some more thinking on that one!

MantaRay - you were totally on the mark there. My positioning was a bit off - I was holding DD a little too low - and simply raising my arm and sticking a pillow underneath her to boost her up a bit made a massive difference. My LC took some photos of us in the ideal position last time I saw her, and when I looked at the photos I realised that I had gotten lazy and dropped my arm a fair bit. The change of position has done wonders to her attachment and I'm paying more attention to having her in a straight line across my body, nipple to nose, which is much better.

Unfortunately when it comes to hunger signals, DD doesn't give me a whole lot of lead time - she will fuss when she's about to wake up for a minute or two, then will start crying before her eyes are even open! I am trying to wake myself up as soon as I hear her stirring and get her ready to latch before she even knows she is awake but I don't always get there in time.

Thank you also for the link to baby-led attachment! I had actually tried this a few nights ago and she managed to get herself to the breast, but as the nipple is still quite a bit too big for the poor thing's mouth, she didn't get quite enough breast in her mouth - owww! It's just a waiting game now until her mouth is a bit bigger and able to open wider without encouragement from me. We have already seen so much improvement in her feeding that the next stage of easier attachment won't be far off now.

Thank you all again for your help with this issue, it's great to be able to draw on experiences of other mamas who have been there and done that!

[Nelle]

I'm so glad to hear things are going better now!