Thrush affecting my supply

I'm posting another thread, sorry!

This is about my supply, my 5 week old has had thrush for the past nearly 2 weeks (that i know of) and as a result has been refusing the breast during the day, but feeding quite well at night (every 3 hours)... however the past 2 nights he did a 6 hour stretch between feeds, which i am not complaining about, but combined with not feeding during the day, i feel he is hungry and too sore to feed, plus now when i attach him i feel my supply has diminished as he keeps cracking it and coming off the breast - whether this is due to not enough milk, or the sore mouth because of thrush i am unsure.... my breasts feel soft, not firm like they used to before all of this started...

out of desperation i gave him expressed breast milk today, i managed to get one lot of 90mls, he drank every drop.... i tried several hours later to express again and only got 30mls (my supply is dropping right), so i topped it up with formula, he drank it, then several hours later again i expressed and got practically nothing, so i made him formula and he drank 60mls... he has never drank much more formula than this amount, its like he gets his hunger satisifed briefly then loses interest/falls asleep...

i don't know what to do, he won't feed on my breasts during the day because of the thrush, but i don't want him to get too used to having milk in a bottle, in case he then rejects me during the night.... i am so over the thrush and other problems i am having i am tempted just to put him on formula as it would be easier in the long run and i would be able to get some rest/help from others.

sorry a garbled post... just not sure what to do.

Oh your poor baby, (and you if my experience this past week is anything to go by)... My little one has had thrush this week as well. Just wanted to check what you were doing to treat it? DDs tongue was so thickly coated with thrush it had gone to her inner lip as well and my nipples were in agony. I had had it with my first DD as well so I knew that that's what it was before going to the doc's. Anyway long story short, I got some Daktarin Oral Gel from the chemist and applied it to my nipples before and after each feed as well as to DDs dummy of a sleep time (or whenever she would take the dummy), 5 days later we're both 100% better. You can just buy it over the counter too which is very handy if you happen to run out.

have just started the oral gel after 5 days of the nilstat drops doing nothing...... will keep persevering with the oral gel, its more the feeding that is frustrating me, as he has a few sucks then gives up and goes without, and my supply is dropping..... i don't want him to be hungry, but don't want him to get used to bottles, as i am suspecting he is preferring the bottle to the breast and i am worried i am falling into a pattern... but again repeating myself, i don't want him to go without milk.... over the past week he really didn't feed during the day at all.... so now i am supplementing with a bit of formula...

i can't wait for it to clear up!!

I understand, keep persisting with feeding him, he will eat if he is hungry... You might have a couple of sucky days where he wants to feed every couple of hours but only for 5 minutes (or is on and off due to pain) but at least that will help build up your supply again. Don't get me wrong my dd is 5 weeks too and I've got a tin of formula daring me to open it (especially this past week) but you seem like you really want to b/f so it may just take a bit of perserverance. Also i'd stop giving him formula or breast milk in the bottle it will probably only confuse him at this point and again, he won't starve himself. Good Luck!

I'm not sure how thrush would affect him, but it sounds like you have a joint situation of breast refusal and thrush.

Have you tried the ABA helpline, 1800 mum 2 mum? They will have good advice on dealing with both. From what I do know about thrush you have to treat both your nipples and your baby's mouth. And you will probably need to wash and sterilise the pump thoroughly after expressing.

The best thing to increase your supply is to bf your baby more often. The less you feed him, the less milk your body will produce. If he is unsettled, try different locations, different holds and quiet environments. Try bfing in the bath, lying down in bed, or similar. Try to relax and make sure he is getting a bf when he isn't overtired or overhungry.

He will guzzle a bottle, because it's not possible for him to regulate the amount that he takes in the way he can with bfing. You may need to encourage your let down before bfing him. It's often better at night when we're more relaxed. Try expressing a little before putting him on (hand or pump), or putting a warm washer or compress on your breast first. Try to relax your shoulders and stay relaxed.

:hug: I would suggest the ABA or a Lactation consultant to help you properly.

Emma, you have had a very difficult start. It must feel very overwhelming for you at the moment :hug:

I tend to agree with Jen that the breast refusal and the thrush might be two separate issues. There are few things to explore here, and while I am happy to give you some ideas here, I think it would be easier for you to discuss this over the phone with a breastfeeding counsellor who can ask more questions. The ABA helpline number as Jen has said is 1800 mum 2 mum (1800 686 2 686) and is a toll-free call. You can ring anytime - it is a 24 hour, 7 day a week service and the counsellors are all mums who have been there and totally understand what you are going through. It really is a fantastic service and I think it would be a huge help to you to discuss what's going on with them.

Emma, how many feeds is your DS having in 24 hours? On average babies at that age have 8 - 12 feeds in 24 hours, so this is a good number to aim for. It can also be helpful to know the signs that your baby is getting enough milk. Ideally he would be having 5 heavily wet disposables in 24 hours, more than one poo in 24 hours (and no hard poo), be gaining weight and have good, elastic skin tone. If you need to give him EBM or formula because he's not showing these signs, then you need to. But it is a good idea to call the helpline, or see a good LC as soon as you can to resolve the problem, as this will impact on your supply going forward.

It is helpful to know that not feeling full is not necessarily a sign of low supply. It is certainly true that bfing often is important to maintain your supply, but it's not time to panic about your supply just yet. As Jen has said, continue feeding as frequently as you can as this is the best way to maintain, or build up, your supply. If your little one just won't feed during the day, see how you go with expressing every 2 hours. I know it's hard work but it is easier to maintain your supply now then try to get it back later.

With regard to the thrush, Jen is also correct that you also need to be treated. You and your baby will continue to cross-infect each other otherwise. If your GP didn't know this, it might be time to find a new one - a bfing friendly one preferably. It is also important to sterilise bottles, pump etc until the infection has passed. Expressed milk is fine to give your baby though.

Emma, please let us know if you we can help you with more information, but I do recommend calling the helpline. Let us know how you go. All the best hun - it will get easier with time :hug:

Dealing with thrush can be hard in the first few weeks, DD1 got it twice, once around 5 weeks and then again about 3mths. It can make them fussier on the breast, but this will also be the case on the bottle to because it makes the infected areas irritated when rubbed, so it probably is a bit more of a case of fussy feeding.

Generally they will feed better and easier at night, there is less stimulation and they are sleepy, so try encouraging the same environment during the day, pick a quiet spot in the house and darken it. Bottles are easier to drink from, it requires less work and they dont take long to pick up on it but when it comes down to it they wont starve themselves they will feed if they are hungry, even with the thrush. Bubs may also not actually be hungry at times when you think, bubs may just be a little unsettled, show some hungry signs, and use a small drink to settle, it takes awhile but you will work out when they are really hungry. DD1 was shocking for it and eventually I used a dummy to settle her cause she always wanted to suck something but was not feeding properly, when she was genuinly hungry the dummy didnt cut it anymore.

Expressing is hard, you will probably always get less than what bubs can achieve, and their is no way of knowing this either, and it definelty is not a guide to your supply levels, so dont feel that because you cant express that bubs isnt getting enough either. Your supply, even though there is the issue of thrush, will adjust to compensate for what bubs wants, so the more feeding the more supply, this is why continued use of formula to replace or top up feeds isnt a good idea.

Your boobies are also feeling softer and no longer hard because your supply is levelling out to the demand, so it doesnt mean you are undersupplying, just that it is the perfect amount now, not excess. Eventually in the coming months they will get to a stage where if you skip a feed they dont get engorged and overful, they tend to stop at a certain volume and hold it for the next feed.

It is also very true about the thrush being transferred from bubs to you and back, so the gel should be applied to both. You can also get the thrush internally in your breasts. With DD1 I got internal thrush the second time and had to be treated with medication, if you are worried about this see your dr. Change breast pads regularly, if you are using washable ones, use an antibacterial wash with them and dry them in direct sunlight. Its also a good idea to expose yourself to air and sunlight as well.

I hope it clears up soon, I understand how tempting it is to go with the formula when things like this happen cause it appears easier, but bf truly is rewarding and easier in the long run.

thanks for the advice...
i have decided i really do want to continue with breast feeding, i just don't know how to do this. i think i will make an appointment to see a lactation consultant... i think my supply has dropped dramatically as it has been about a week and a half and he has literally barely been feeding during the day AT ALL.... i'm talking maybe a feed at 6am, a quick suck at mid day then nothing until the evening.... i just don't see how he can be getting enough... is it true they won't starve themselves??? i feel like i'm not so sure... he seems hungry but cries when i put him on, no matter what i try... actually the one thing that sometimes works is if i put him on while he is asleep, and try to wake him, sometimes this work and he will take a feed.... i'm now in the predicament of trying to get him to feed during the day on breasts with minimal milk!
i am pumping as we speak and am going to just try to pump to increase my supply again, but its hard as i don't want to pump all the milk, then attach him and he gets angry as there isn't a good let down... i'm unsure whether he is sore from the thrush, angry at no milk, or perhaps the letdown is too strong....

sometimes during a letdown the milk spurts out like a tiny fountain with force, even when he isn't sucking... this is of course after many many hours of no breast feeding so the breasts are full...

i just want to cut out all formula whatsoever and only give him breast milk, but feel expressed breast milk from a bottle might be necessary if he hasn't fed all day... do u think ebm from a bottle is going to contribute to the breast refusal....

before he had thursh everything was going so well... i'm so disappointed. i have taken oral thrush meds as well as applying the cream... my nipples don't feel sore.... i hope it resolves itself... i might get him weighed tomorrow just for piece of mind.

thanks again, its a really trying time for me at the moment.

Emma, it is a tough time and you are doing a fantastic job of getting through it :hug:

Just a note on thrush meds - oral thrush meds only work for internal thrush. The meds won't do any harm, and sometimes when you have nipple thrush, you have it internally too, so they could be a good idea. But they won't help nipple thrush if you have it. And if your little one has thrush in his mouth, there's a good chance that it is either in your nipples too, or soon will be.

Your idea to see a Lactation Consultant (LC) is a good one. A good LC can figure out exactly what's going on and give you strategies for dealing with it. A good place to start to find one in your area is here - Australian Lactation Consultants Association Ltd - ALCA - Find a Lactation Consultant. These LCs are all IBCLC qualified which means they have done extensive training and passed difficult exams.

You could be right that he needs EBM, and you are also right that doing so can keep the cycle going. Getting enough milk into him is the first priority though, and an LC can help you with this further. How many nappies is he having in 24 hours?

Do you think you'd be comfortable ringing the 1800 mum 2 mum helpline? They also have a list of good LCs in some areas also.

Keep up the great work hun. This is a very hard time, but as the saying goes, this too shall pass :hug:

Oh hon, I'm sorry you've had such a difficult start! :hug:
Can you call the ABA - they are really wonderful. Just mums like us - they understand. Just talking (to someone in real life) might help you to feel less alone. And I remember feeling so alone with struggling along in those early days.

Do you have people to help you out - partner, family, friends...? Sometimes that makes all the difference.

All the best :hug:

i have called the ABA last week when he was refusing the breast, before i knew it was oral thrush... i might see how i go with the LC...... there is a breast feeding support house near me which i went to with my first baby so am comfortable going back there....

i tried to feed him just then while he was sleepy, he sucked for 5 minutes or so then cried, so i gave him 90mls of expressed breast milk which i had just pumped prior, and he took it all.... he seemed to suck better after i had expressed some milk, even though he only lasted 5 minutes, it is better than 30 seconds.... i might try expressing just before feeding him next time and see if it helps, maybe he is frustrated with waiting for a let down...

grrrrr i just want to get rid of this thrush..... i will keep persevering....