Expert: Tanya Phillips, IBCLC - 5/2/2004

Question
I am nursing both of my daughters, ages 14 months and 4
years.  When my elder daughter was about 18 months old, I
developed a persistent case of what I thought (and my
pediatrician, La Leche League leader and much research
confirmed) was thrush.  I treated it with everything from
vinegar and water solutions to nystatin cream to lotrimin cream to
an eight
day course of diflucan.  None of these remedies helped; in fact,
my skin got progressively more red, irritated and painful with
each new treatment.  The irritation didn't clear up until I was more
than three months pregnant with my younger daughter and
my milk supply was almost gone.  (Elder daughter nursed
throughout the pregnancy.)  When I described the situation
to my midwives, they theorized that the inflammation,
redness, itchiness, peeling skin, cracked and bleeding
nipples, etc. was not due to thrush, but to some allergy or
sensitivity that I hadn't identified.  The only thing I could
think of that had changed at around the same time that the
"thrush" developed was that we had started using baby
toothpaste on my daughter's teeth.

I had no problems
nursing my second daughter until she was just over one
year old, when the same symptoms emerged again.  Again,
we had just started using the enzyme toothpaste to brush
her teeth.  I made the connection immediately and got rid
of the toothpaste, but I am still having horrible pain and
the areas that started with itching and peeling skin have
gotten much worse.  Now I have open sores all over my
nipples and areolas.  I am wondering whether it is possible
that these lesions are related to cold sores.  They look very
much like cold sores and my whole family has been sick off
and on with a nasty virus for the past couple weeks.  I had a
cold sore on my lip a week ago, right before these really
terrible lesions developed.  My younger daughter currently
has a small sore that looks a bit like an infected pimple
next to her nose.  Could the cracks and irritation that I had
from (probably) the toothpaste have been an entry point for
the cold sore herpes virus?  If this is possible, can you
suggest anything for treatment?  I have nursed through a
lot of pain before and I will get through this too, but if
there is anything I can do to speed healing I would like to
try it.  (By the way, I was cultured for all manner of
infections, STDs, etc. during both pregnancies and the only
things that got a positive result were beta strep and e. coli
during the first pregnancy; all negative results during the
second.)

Answer
Hello Brigette,
Way to go for sticking to nursing both of your daughters.  I tandam nursed as well, it was so easy!

Unfortunatley, It sounds like you have the herpes virus on your nipples.  It is definitely possible to get it there.  You can get sexual herpes on lips or breasts or cold sore herpes on breasts and genitals. (either way)

http://www.babycenter.com/refcap/baby/babybreastfeed/8685.html

Fortunatley we parents love kissing on our babies so much, but sometimes the virus is passed.  In its contagious periods it can be passed much more easily.  The breast is always a 2 way stream.  Babies pass things to moms and the reverse is also true.

In cases of persistant thrush, please try gentian violet first at 1/10th strength (use water to dilute)Always treat mom' nipples and baby's mouth. And throw away tooth brushes after 3 days on treatment.  Beware it really stains bad.  Do not use longer than 3 days, once a day.

Best wishes,

Tanya Phillips, IBCLC