Wednesday, September 23, 2009

Thrush



Addie and I have thrush. Thrush is *just about* one of the most miserable physician conditions you can share with your baby. It makes the inside of the baby's mouth raw and sore...adults describe it as feeling like their tongue and cheeks are "on fire".* So, I suppose the fussing when she's nursing sometimes is from thrush. On the mother's areola, it looks raw, red, and sometimes like blisters...it causes horrible shooting pains in the nipple if the yeast gets inside the milk ducts. It looks like little white patches on the baby's tongue, inner cheek, lips, and sometimes even their gums. If you try to rub the white off, as any self respecting mama might do in the bath when she assumes it's milk, it is tough to do, and if you succeed, it is red and raw underneath. It might even bleed. The worst part is you still have to nurse while you are treating yourself and the baby, both of you in considerable pain.

So, I knew this was coming. I mean, I did get a horse dose of Clindamycin in the three and a half hours before Addie was born because I tested positive for Group B Strep (three times in spite of my efforts to populate myself with a planet's worth of Lactobacillus GG with probiotics galore). Now, I am not convinced this was even necessary and I told my doctor (and I quote) "I am just very concerned about taking such a huge dose of intravenous antibiotics and the risk of thrush while I'm trying to establish a nursing relationship with a newborn". After all, you know the propensity the medical community has for using the proverbial pharmaceutical crane to crush a fly... See, there is no real fool proof evidence that the antibiotics work, and the risk of infection is next to zero (it is a normal skin bacteria, which one would assume many many many people have exposed their babies to for millenia in labor with no ill effects). However, considering the severity of illness with babies who have Group B Strep infections from exposure, I decided not to take any chances, even though I felt like a tool for buying into the hysteria justifying overmedicating people in labor. Plus, we saw first hand how serious it could be when Gillian contracted it in the NICU, and when sepsis started making her desaturate she required two blood transfusions. So, we weren't messing around. I mean, I don't begrudge being treated for something as long as we know it works.

Speaking of which, we started a Nystatin marathon yesterday when I emailed my doctor and said I KNEW IT. I, ever sensitized to the possibility of this happening given how much IV antibiotics I got in labor, had looked at pictures before Addie even made it into the world to educate myself on what to look for. I was required to take Addie to a "newborn clinic" when she was a week old. It annoys me that I had to do that, because I have a pretty good handle on how to be a mom now that I have been one for three whole years. Plus, the people who see you are medical residents, and I'm pretty sure I know more than most of them about newborns (I am also sure if you took a poll, 99% of them aren't parents at all, yet they are giving parenting advice). Anyway, the clinic cleverly makes this the visit where you register your baby as a patient to force the issue. So, I saw two residents and a behavior specialist/lactation person (clearly not an expert if she didn't know thrush when she saw it either). One resident, who was maybe 24 and a female, said "Poor Thing" to me when she saw my PUPPPS rash (can I tell you how much I love condescending sympathy from a person that much younger than me?? a simple "that really sucks" would do). She didn't even know what PUPPPS was. I explained it to her. The other resident, the more seasoned one, did Addie's exam. I told him I thought she had thrush and explained that it wasn't too crazy a possibility given the GBS treatment. He took a quick look and told me the white stuff in her mouth was milk. I told him Gillian never had that in 16 months of nursing and told him I thought it would probably wipe off if it was milk. He told me something else justifying his opinion, and I just let it go.

I feel like Mother of The Year, if you really want to know, for not trusting my gut on this. Because of that resident's incompetence and my stupidity, Addie and I have suffered for nearly three months. I have thought a million times, "I certainly don't remember nursing being this miserably painful with Gillian". Addie is often fussy when she eats and pulls off and arches her back and whines and cries. I thought it was just the witching hour, or that sometimes her stomach was upset. I never considered that maybe her entire mouth might feel like it was full of fire blisters. My breasts look like they have giant red ring worm circles around the nipple. I have been slathering myself with Lanolin, hoping to ease the pain, but ironically, that just makes it worse! Oh, the irony-yeast like nothing better than locking in moisture with the tar like goo that is Lanolin. I am almost through an entire tube of that, and I didn't even get through an eighth of a tube in 16 months of nursing Gillian.

The worst part of this whole deal, besides the unnecessary Pain and Suffering, if the fact that this infection (candida albicans, if you want to know) is VERY HARD TO KILL. Like, think lice with sterilizing your entire house. I know several women who have had to take weeks of antifungals, while concurrently dosing baby's mouth to eradicate the yeast (and you have never had fun until you try to give a baby several milliliters a day of any liquid that is not food-think 2 mL in, 1.75 mL out; choking and gagging...God love her, Addie keeps smiling at me in spite of the fact that she must be convinced I am trying to kill her...). The worst part is that I know as many women who have fought it for months, with no success. They and their baby just keep reinfecting each other. All I can do is pray it dies off for good. And that my nipples stop feeling like Addie is a piranha when she nurses. And that when Addie is better, she will magically love bottles (that struggle is a whole other post). Because I am going back to work in two weeks. Ack.

Wednesday, September 2, 2009

I am Glamorous



See what mothers go through?? There has been a good many blowouts this time around. Nothing says "VOGUE" (or, as it were, screams "I AM A MOTHER") like runny breastmilk poop on your pants (except poop-that-really-wasn't-that-much-so-you-didn't-feel-like/have-the-time-to-change and now there's a little dry yellow stain on your person somewhere).

I love Addie, but I am mystified by the thermodynamics that must occur to make the poop miss inches of diaper only to reappear on the lower back or thighs. Amazing.