Rare bacteria - not fun!

DD is 1 month old now and in the last week or 2 I've developed really sore nipples and sometimes shooty pains in my boobs. At first the LC thought thrush, since DD also had a red bum and white tongue. Bum has cleared up with cream and tongue is a work in progress. But my nipples were swabbed last week and no thrush on them but a rare bacteria called pseudomonas luteloi.

Apparently it's very difficult to treat with antibiotics, so most of the time they don't bother, or you're on 2 at a time. Neither the GP, LC or CHN knew how to treat it. I'm getting a cream from the hospy tomorrow that MIGHT help but not sure.

In the meantime I am expressing and using EBM to feed to give my nipples a rest, but DD keeps catching up with me and I keep needing to use my boobs every now and then.

We've tried formula a few times as a one-off attempt to get ahead of DD so my nipples can get a proper rest, but she has thrown up every time. We now know she doesn't agree with S-26 or NAN.

I really want to keep BFing but if this cream doesn't work I'm not sure what to do! :(


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Was thrush present as well?

I have been battling some awful thrush, but one of the ointments I was given is kenacomb, which is antibacterial and anti fungal.

Despite my terrible pain at times I have managed to keep breastfeeding for twelve months now. For me I have to use cream like daktarin regularly and periodic anti fungal treatments.

Tbh I'm just shocked a white tongue in bub, red bum and shooting pains in breast is NOT thrush. Maybe I should go get swabbed???

That's the cream I'm getting today! Is it any good? Does it work? Do you have to wash it off before feeds?

Even if you got swabbed, Kenacomb is the best they can do for me, so it wouldn't change your treatment?

I'm also really surprised thrush didn't show up too. What do you use for your LO's tongue?

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Oh Phe you poor thing. How frustrating! Have you done lots of online research into that bacteria? If they know it exists there must be other people who have treated it successfully somewhere in the world. Try the ABA perhaps too? When I had very painful latch issues the ABA were incredibly supportive - whether via phone or email.

I had a mystery infection in my nipples when DD1 was a nb, Kenacomb was my lifesaver, i still remember with that little yellow tube with fondness ;) I used to hold DHs hand and squeeeeze with the pain when i had to feed DD, but we took it one feed at a time, and i made him swear to support and encourage me rather than 'fixing it' by switching to formula. I used to squeeze in an extra expressing to try and keep ahead, and we finger and line fed her as i was scared of nipple confusion. The pain faded over the next 10 days or so.. and she fed till over 3. You can do it Mama xxx (I know it bloody hurts though)

Oh yes definitely put in an extra express to stay one step ahead so you are not sitting there expressing the milk while bub is screaming and impatiently waiting for it. I did this in the first five days after birth.

I haven't had a chance to express at all today! I think it's affected my supply too. Until yesterday my boobs felt all full and bursting if I went more than 3 hours, but today I'm getting to feeding time again feeling floppy still. DD isnt going as long between feeds either. Is my supply dropping? This is NOT good cause she has reacted to the 2 formulas we've tried so far :(


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Just keep expressing and/or feeding direct and your boobs will adjust to make enough... You just have to *use* them enough. Take heart Phe :)

They're really hurting me even more since direct feeding and there are more shooting pains :(

Problem is, when do I express? If she is eating every 3 hours, I'm only getting 20-30ml after a feed. If I expressed before a feed there would be nothing for her and the feed would take forever. In between and a mix of both problems?


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Plus, I haven't changed the frequency of when I do one or the other, so why does it feel like my supply has dropped?

Thank God for LC appointment tomorrow! - sorry, today!

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Your boobs will sort it out, it might take a few days that's all! I'd express between feeds. It takes about twenty minutes for your boobs to refill, so wait twenty minutes after a feed and express.

Kenacomb definitely helped, but I definitely have thrush, so I have also needed oral antifungals.

Bub hasn't had a white mouth since a newborn, so he doesn't have it necessarily, but we used daktarin gel. Remember babies get a milk coating on their tongue anyway...you LC will be able to tell you the difference anyway.

Are your nipples cracked at all? Or looking peel-ly? Does the pain go through to your back? I'm just intrigued because it all sounds like thrush.

What's your diet like? I would be cutting out sugar and alcohol in case thrush is the too.

And too much yeast is a no-no too. Good luck with the LC Phe- thinking of you.

Haven't had alcohol since before ovulating the egg she was :) sugar... Oh boy, so hard to do! Yeast? Nearly impossible. Breakfast is always sugar or yeast or one of the 2. If I don't have honey or jam on toast, I have Vegemite. If I don't have toast, I have corn flakes with honey. I already have so many dietary restrictions, so those are basically my only breakfast options :( happy to cut one of them but since both are so staple in my diet I need at least one :(


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I'm also so exhausted from a little Miss who is an inefficient feeder and takes 1 - 1.5 hours to feed that I forget to give her her Nilstat drops at the end and I have zero energy left to express at night :( but if I 'sleep when baby sleeps' too much, I get insomnia.


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How did your LC meeting go?

It's at 1pm


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Oh no! That sounds terribly painful and frustrating.
Where are you in Perth? Rebecca Glover is in Perth and she's a bit of a guru at sorting out tricky problems. Sometimes you need to see a few LCs to get it right.
It is entirely possible that there are several problems here. So there was no nipple damage or pain prior to 2 weeks ago? In the first month, was she gaining weight and growing fine? How many wet & dirty nappies is she getting?

So right now you're trying to express between feeds so that you can skip the occasional feed to rest your nipples, is that right? Does she take both sides at a feed? If not, you could express the other side while she feeds. Or, try expressing 30 minutes or so after the feed. You mightn't get much at first, but the more milk you remove from the breast, the more you'll make. It's quite normal for supply to settle down at this stage and for breasts to not 'fill up' - it's not a reliable indicator of supply. Likewise, babies are sometimes fussy and want to be at the breast a lot. output can be the easiest way to track input - wees and poos I mean.

I hope your LC apt is fruitful!

Sometimes difficulty expressing is due to some pretty simple things - check the seals on the pump, and that the size of the flange is the correct size for your nipple - too small and you get significant damage; too large and expressing is very inefficient. And because of the thrush, sterilize the pump bits each use (not required once you've squashed the bugs).
If you are going to be expressing seriously then hire a double pump from the ABA or from a chemist - they get more out in less time and give you more time for other things (like nilstat and sleep!).

Have had one of those for 4 weeks now. That's what I'm using and it's taking half an hour. But that was when I was expressing only, not feeding too. I guess that gives me an indication of how long DD should be on the boob right?

Anyway, LC was fantastic! WAY better than KEMH ones who everyone has hyped up as saints. From this appointment we were able to find:

- DD DOES suck inefficiently so we have some exercises to do with her during 'play'
- I didn't have her in a correct position, though attachment is fine
- my pain IS thrush and keep going with Kenacomb for me and Nilstat for DD but I can also get some very expensive wonder tablet for me too
- DD has reflux :( we were given treatment suggestions so will pursue those

It's going to be a hard road ahead putting these things in place, so hopefully it works!


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Oh so glad you have some answers to go on. XXX

Sounds like you've made progress!

Poor DD is so miserable with the reflux right now, it breaks my heart :(


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What a rough trot you are both having! You'll get there. X

:hug: hope her reflux starts to ease off very soon, must be hard to see her so uncomfortable :hug:

btw...your new avy is really nice!

Yes it is gorgeous isn't it Hestia :P ;)


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Ok great to hear you've made progress! Can I please urge you to use the cream for two weeks after the symptoms have gone. When ds and I first had thrush I didn't follow a proper treatment plan and almost one year on I still have it! Kenacomb is great, but you may need an oral treatment too, such as nilstatin or diflucan (or both).

I would also suggest you cut out all sugar, fruit and alcohol from your diet, and try to rest as much as possible. Zinc and magnesium have also shown to help, and in fact zinc has been a miracle treatment for me.

Good luck with it all. Breastfeeding is so rewarding, but some of us have a rough trot of it!

:hug: you're amazing!

No fruit? Oh dear :( yes I'm definitely going to try no sugar, but I'll really miss fruit!

I had a diflucan today so FX it works! Will continue with Kenacomb too :) thanks!


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How long does Diflucan take to work?


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Hi Phebee,
I am also dealing with nipple thrush. I took 3 Diflucon tablets over 6 days. Is that what you are doing? I am also using Kenacomb. Unfortunately, I stopped using the Kenacomb the first day that I finally had pain free feeding. Then the thrush flared up again. So I second Arcadia's suggestion to keep using for a while after symptoms disappear. I only have it in one breast. The Diflucon seemed to help but I think it was the Kenacomb that made the most difference. My LC told me to put on a small amount so that it only glistens on the nipple. I don't wash it off because I put it on after a feed and there is usually a 4 hour gap before I feed on that side again.

I was thinking of going on an anti-Candida diet but a friend who is a Naturopath (and ABA counsellor) told me that it is too restrictive when bf. She told me anti-Candida diets are designed for people who have been unwell on a long term basis with systemic candida.

I have decided to only restrict my consumption of sugar, but not fruit. And I don't drink alcohol anyway while bf a young baby.
Big hugs, I know how awful it is. I have shed many tears. But once the Kenacomb kicks in, you won't know yourself!

Still hasn't done anything :( the Diflucan got rid of the shooting pains in my breast, but my nipples are still red and sore. What's worse is DD keeps fidgeting on them and coming off and on. I feel like they're never going to heal :(


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I'm sorry to hear that :( Are you still using Kenacomb? I was told to put it on 3 times a day. I still have nipple pain but it is bearable. My DS has tongue tie so I know that causes some of my pain too. For nipple thrush, I was also told to wash my nipples in a solution of bicarb soda and water - 2 teaspoons bicarb to 2 cups lukewarm water.
I have also heard that you can do the Diflucon treatment again but I have not felt the need to do that. My LC also gave me a nipple shield (I haven't used it). Did your LC discuss this with you?

:hug:
If you've been through all that treatment then the thrush should be good and gone. How's the treatment for the infection going?

Yes I second madB, if the thrush treatment plan isn't helping, it's probably because of that other bacteria. Even at my worst I found thrush treatment the only thing to help. My problem is I'm great while on hard core anti fungals, but as soon as I stop taking them or using cream, it's all back again...so my immune system can't kick the candida.

Fwiw the anticandida diet is very restrictive and I've had to modify it for breastfeeding (I eat spelt and basmati rice and lots of veggies and meat).

I would either look at stronger thrush treatment like oral nilstatin and diflucan (I had to take both together as per the royal women's hospital website) or I would be looking at different antibacterial treatments.

What about tea tree oil based creams? I just saw one in price line that is ant bacterial and anti fungal and is created from tea tree oil.

The bicarbonate soda bathing also works well. You can alternate with vinegar bathing too.

Ooh thanks, I'll try the bicarbonate solution first and see how that goes. Diet is a last resort since mine is so ridiculously restricted anyway. I am using a nipple shield now, but I did at the beginning then quit after a day cause they were so annoying. But I'm back on it now - or its back on me, rather :P Kenacomb has been at least 3 times a day, often more as I do it after every feed. The Diflucan was only one tablet... was I supposed to have 3?

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Hi,

if you have that bacteria you need to treat it - and yes you really won the jackpot for rare and tricky nipple problems. Very very often people go down the path of long and exhausting treatments for thrush and they don't resolve......because it's NOT THRUSH. It's a bacterial infection. Your LC and dr are on the right track. Kennacomb is the go - but there is always plan B which may involve heavier duty antibiotics. But you can still breastfeed. So, don't tie yourself in knots with your diet or thrush treatments - they won't cut it. Use the kennacomb and if that doesn't work go back to the doctor. I also suggest you speak to Rodney Whyte at the Monash Medical Centre drug info line (some - one will provide the number) he is a font of knowledge and is happy to speak to mums

03 9594 2361, office hours in Melbourne.

Thank you so very much!!


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Also have a look in this thread and see if there are any parallels:
https://www.bellybelly.com.au/forums...in-176215.html

Hope things improve soon.

Phee - sounds like you've got some good advice here :) Such a good place for support.

I hope it's improving and DD is learning to attach properly and not hurt her Mummy. Remember to take a deep breath and know that you're doing a great job being a loving Mummy to DD. Keep us in the loop, it's worth keeping it up, give it time to improve.