The Meyer Protocol for Thrush Treatment

 ​PREVENTION OF SORE NIPPLES: To prevent sore nipples, ensure a large amount of areola enters baby’s mouth! Do not coat a thrush infected nipple with expressed milk for healing- it actually feeds the yeast and makes it worse. A simple rinse will do.
  
PROBIOTICS: You want the fancy “Women’s Health Probiotics” .hese are for the mother to take.

THRUSH: TREATMENT OF Candida Infection NIPPLES will need the care of your OBGYN for APNO ointment for signs of Thrush. Wipe off excess. The following link is a sheet to print out for your Dr.
http://www.breastfeedinginc.ca/content.php?pagename=doc-APNO but if that link is not working you can link my directions for healthcare providers for APNO found on my blog.
This will have dosing directions but typically you apply a thin sheen over the nipple and areola each time after nursing. This means use a ½ pea sized amount and rub your fingers together until it disappears, then use it on your nipples. In this amount it is compatable with breastfeeding.
 
 If the APNO does not resolve the thrush alone:
“Persistent Pain” Academy of Breastfeeding Medicine 2016,
 "Oral fluconazole (200 mg once, then 100 mg daily for 7–10 days) may be used for resistant cases.  Before prescribing fluconazole, review all maternal medications and assess for drug interactions. Do not use fluconazole in combination with domperidone or erythromycin due to concern of prolonged QT intervals.”

Evidence of Pediatric Thrush:
If the Baby has a small amount of light white on the tongue that will not wipe off, Contact the Pediatrician so the infant and the mother get concurrent treatment and do not pass it back and forth. Remember the goal with oral nystatin is to paint the inside of the babies mouth, vs put it alongside one cheek just to be swallowed. Spread it around!

LAUNDRY: when you have thrush will need Grapefruit seed extract and it into your wash to help kill candida on clothes.  Dry on hot, or sun dry. Bleach if you need to. Be aware that anything that touches your breast may hold onto the spores, so separate the towels; you get your own. Boil things that go into your baby’s mouth or steam them in a sterilizer bag (Bottle nipples, chewwies, pacis, pump flanges) I think a steamer bag is easier than boiling everything. Please carefully reconsider the instructions from anyone to apply grapefruit seed extract to your nipple neat- it is a great way to chemically burn your nipple.

CANDEX: Candex is a small tablet that slow down cellular division of candida. Its great for adults with chronic overgrowth of candida (Thrush) It's compatible with breastfeeding/chestfeeding. 
 
The Thrush Plan:

1. Use the APNO
2. Take the probiotics (Garden of Life Raw Vaginal Care)
3. Call Dr  for Nystatin tx for your baby
4. Ask your Dr about whether you are a good candidate for oral Diflucan
5. DO NOT USE Gentian Violet ( caused cancer in many studies. We used to suggest it but we do not anymore)
6. Add in Candex for yourself .

 
                                                                                                                           
Serena Meyer, RN, IBCLC, RLC