Wednesday, February 25, 2009

Yeasty Beasties…Dealing with Thrush

When a mother has been nursing comfortably for several weeks or months, then suddenly begins to have sore nipples, she may have a yeast infection (candida albicans), also known as "thrush." The pain from thrush does not diminish after latch-on; in fact, sometimes it continues even after the baby has stopped nursing. The nipples may have a red or dark pink irritated appearance, or look very dry, and the mother may report that they are itchy or have a burning sensation. However, thrush might be present without any external symptoms at all. Another common symptom of thrush is shooting pain deep within the breast after or between feedings. Some mothers report it as pain in the area under their arms (the axilla); others describe a pain shooting through the chest wall toward the back. If you are having these symptoms, then you and your baby both need to be treated.

Babies can have thrush in their mouths, as well. It looks like little white patches inside their cheeks and lips or on the roof of the mouth. Some babies don't have any symptoms in their mouths, but have a red, angry looking diaper rash that is caused by candida. Whether the baby has any symptoms or not, however, both mother and infant must be treated to prevent the recurrence of thrush.

One of the oldest and quickest (and messiest) treatments is gentian violet. Dip a q-tip in the gentian violet and swab the inside of your baby's mouth right before you nurse. After you nurse, you will have gentian violet on your breasts as well. If the nipple and areola are not covered, use a q-tip to make sure they have sufficient gentian violet. Doing this once a day should resolve the problem within a week. Conversely, you can apply the gentian violet to your nipple and areola just prior to nursing, and baby will get the benefit as well. However, may mothers don't want the mess of gentian violet. Thankfully, there is another great option.

Dr. Jack Newman recommends an All Purpose Nipple Ointment which must be compounded by a pharmacist. If your physician is unfamiliar with this compound, you can send the link from Dr. Newman into his office. The ingredients include the following:

  • Mupiricin
  • Betamathasone
  • Micanazole (flucanazole may be substituted)

Occasionally the yeast infection will be intraductal which requires a systemic treatment. Flucanazol (Diflucan) is widely recognized as an effective treatment for systemic yeast. An initial dose of 200-400 grams followed by at least 2 – 3 weeks of 100 grams a day has been shown to provide long-term relief from candidiasis. The treatment must continue until you have been symptom free for 7 days.

No doubt about it, yeast is very frustrating. You will need to boil all your baby's pacifiers and nipples to make sure you kill all the yeast. Moms who take immediate action and stay on top of their yeasty beasties can beat this annoying problem!

Monday, February 23, 2009

Breastfeeding Nugget of the Week

One of the crunchy practices that many granola (and not-so-granola) mommies do is breastfeed, and it's a cause that's near and dear to my heart. So instead of writing an introductory post (which would probably be helpful to y'all; I'll do one later, I promise!) I'm going to make my first post into something that I hope I'll do every week - a breastfeeding nugget of the week. Each week (or as close to that as possible) I'll write something to do with breastfeeding - a factoid, a tip, something that's happened in the news lately that pertains to breastfeeding. For many of our readers, some of this may be old hat; for those of you who aren't as well-versed in the ways of lactation, I hope this can be of some help.

Breast cancer is one of the biggest health concerns in the US and western world today, where rates of breast cancer are higher than in developing/undeveloped countries. Those rates are also on the rise in developing countries, probably for a whole host of reasons that are complex and not as simple as declining rates of breastfeeding. In the US, breast cancer is the most common form of cancer amongst women, other than non-melanoma skin cancer.

Now, cancer in general is on the rise amongst our population, and there is much that contributes to this. Longer life spans naturally lead to more problems. Technology is constantly changing, and while many of those changes are good, some of them are not. We put things into our bodies that were never meant to be there, whether through food or through medicines or through the very air we breathe. There are so many possibilities as to what has caused the surge in cancer rates that it is infeasible to point to one thing and say, "Do this to avoid XYZ-type of cancer."

So please forgive me as I seem to do just that. :P

A recent study analyzed the combined data of 47 studies done in 30 countries, giving the researchers information about 50,000 women with breast cancer and 97,000 women in a control group without breast cancer. Their conclusions showed that of those women who had given birth, every year of breastfeeding decreased their risk of developing breast cancer by 4.3%. These percentages held true across the board, whether the woman was young or old, pre- or postmenopausal, whether she lives in a developed country or a developing country (1). The take-away from this is obvious - that the incidences of breast cancer in developed countries are higher because we do not nurse our children, particularly for extended periods of time.

I know, I know; I can hear some of you in the back saying, "Four point three percent? That's, like, barely worth noticing." And you might be right, if it weren't for the fact that that 4.3% is compounding per year that you breastfeed. That can certainly add up to quickly!

It might be that breasts are best protected against cancerous cells developing when they are used in the way that they were designed to be used, with the breast tissue fully developed from breastfeeding (2). It might be that the lack of periods associated with exclusive and extended breastfeeding and the resulting lack of hormonal fluctuations on a regular basis may leave the breasts (and ovaries and uterus) less vulnerable to cancer (3). It might be (and probably is) a combination of both.

But the big statistic worth noticing comes from a 1994 study that shows that women who were breastfeed themselves had at least a 26% less chance of developing breast cancer, and in some cases as much as 31% (4).

That is huge. Absolutely huge. Can you imagine how much lower our rates of breast cancer would be if every single woman breastfed her daughters for one year each? They'd have the protection of themselves being breastfed by their mothers, and then they'd have the additional protecting of actually breastfeeding their own children. The number of lives saved, the number of resources that could shift to focusing on other needs, the amount of money and time and energy saved in medical's staggering to think about.

So yes. We all know that there are many, many reasons to breastfeed, or at least to attempt to breastfeed. But this? We, the women of the world, the mothers of the world, have the ability to directly affect something that is a huge health concern and directly affects mortality rates. We have the ability to change the face of the medical field as we know it, even if we never receive credit for it. This is powerful, and awe-inspiring, and breathtaking.

Let's take this chance, ladies, and change our world!

1) Collaborative Group on Hormonal Factors in Breast Cancer. "Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973 women without the disease." Lancet
2) The Womanly Art of Breastfeeding, 7th Ed. pg 383.
3) The Womanly Art of Breastfeeding, 7th Ed. pg 379.
4) Freudenheim, J. et al. "Exposure to breast milk infancy and the risk of breast cancer." Epidemiology 1994; 5 (3): 324-331.
2002; 360: 187-195.

Saturday, February 21, 2009

What is a Conservative Granola Mommy?

I first heard the word "crunchy" used to describe moms who practice attachment parenting when I was at a River City Slingers meeting. This amazing group of sling-wearing mamas was meeting in Decatur, AL, to encourage each other and share the latest in baby slings, cloth diapers, and other attachment parenting tools. That day I discovered that I was a crunchy mom. My oldest was 18 and in college before I realized there was a name for moms like me!

So just what is it that makes a mom crunchy? I think it is an overarching mindset of putting her baby's best interests ahead of herself during this season of life. Attachment parenting as described by noted pediatrician Dr. William Sears is focused on meeting your baby's needs in order to help him learn trust from the earliest moments of his life. When you immediately feed your hungry baby, or pick up your crying baby, or soothe your fussy baby, you are teaching him that his attempts at communication work. Typical crunchy mom behaviors may include extended breastfeeding (nursing past the first birthday), co-sleeping and/or parenting your baby to sleep, and baby wearing. Other crunchy behaviors may include making your own baby food, growing your own food or buying organically grown food, cloth diapering, choosing to selectively vaccinate (or not vaccinate), and home schooling. Not all crunchy moms do all of these things, but if your parenting includes two or three of the practices listed above, you can safely say you're crunchy!

The phrase "conservative granola" has been around for a couple of years. In 2007 a site by that name was established. Unfortunately, it appears that hasn't been much recent activity there. However, the phrase works well to describe mothers who practice attachment parenting principles based on a Biblical understanding of God's design for mothers and babies. A mother may be Protestant, Catholic, Jewish or espouse another religious view, but if she is parenting based on her God-given intuition, she is a Conservative Granola Mommy!

All parents are welcome here. I am unashamed in my Christian faith, and that will certainly be evident in some of my blogs. Nevertheless, any mother, regardless of her beliefs, who wants to learn more about parenting her baby intuitively will be able to glean some seeds of wisdom here. As the owner of A Nurturing Moment Maternity and Nursing Boutique, I would love to learn about any products that help you parent better. We welcome your comments and input and look forward to getting to know you!