Amy Spangler

Need help treating a yeast infection

Dear Amy,

We are having a problem with yeast!  I have tried gentian violet and it has once again returned!  I was told about an herbal antibiotic " Silver."  Do you have any information on this and breastfeeding?  Do you have any advice?





Yeast grows in dark, damp areas.  Therefore the best treatment is to expose the affected areas to air and sunlight (about 3-5 minutes a day), being very careful to avoid sunburn. The recommended treatment is an anti fungal ointment, cream, or solution applied after every breastfeeding for 14 days.  If the topical agents are ineffective, gentian violet can be used.  Apply a 1% solution once a day for 3 days.  Resistant infections can be treated with a systemic medication such as Diflucan, however, you would need to talk to your doctor or your baby's doctor and obtain a prescription. Regardless of the treatment regimen, it is very important that both mother and baby be treated at the same time.  In addition, you want to treat any family member with symptoms of infection.  Because yeast is part of our normal flora, you never eliminate the yeast, you simply reduce the number of organisms and the symptoms of "overgrowth".  Yeast can be persistent and some women choose to eliminate from their diet those foods that support the growth of yeast such as sugars, alcohol, wheat, dairy products, nuts, and juices.  Whether this is effective remains controversial. I am not familiar with the herbal antibiotic that you mention.

How can I extend the length of feedings?

Hi, Amy!  I have a 3-year-old daughter who I breastfed for 13 months.  I now have a son, Connor, who I have breastfed exclusively from birth. However, he is starting to drive me crazy since he only eats for a very short time, but wants to eat again as soon as one hour later! (Sometimes he realizes that he is still hungry within 15 minutes or so and wants to eat again.).  I have tried the darkened room routine with no results.  I have never been able to get him to nurse from both breasts in one feeding since he decides to stop if I ever try to switch sides. Because I am concerned that he get hindmilk, I have basically kept him at one breast throughout each feeding (then started the next feeding on the other breast).

So, do I just force him to cry until I "schedule" him to three hours apart?  What is this "breast compression" thing I have heard about - would that help?  Or should I just resign myself to a nosy eater who won't pay attention once he is a little full? This is very difficult with a busy 3 year old.  I just can't run my day around his eating schedule!  (Even though he is awfully cute!) Thanks in advance.





While every child brings their own, unique personality to the table, behavior modification for the benefit of family harmony (as well as mother's sanity) is sometimes necessary!  The "breast compression" you refer to is similar to "alternate massage." Both are techniques for increasing the flow of  hindmilk and are done when a baby's sucking pattern changes and he stops swallowing.  You simply compress the milk sinuses with your thumb above and your fingers below, or you gently massage the breast with the flat surface of your middle fingers.  If Connor refuses to cooperate and extend the feeding, you may need to hold firm in your decision to wait at least 11/2 -2 hours before you allow him to breastfeed again.  You can extend the feeding interval by 15-30 minutes a day until the desired interval is reached.

Want to have a frozen embryo transfer - 
can I still breastfeed?

My husband and I would like to do a frozen embryo transfer within the next two months.  I am currently breastfeeding and would like to until my son is 1 year.  Do you know if it is possible to continue to breastfeed my son and do a natural FET?  If not, and I need to wean him, how do I get him to take formula if he has refused it in the past or can I wean him onto something else?





I would recommend that you contact your doctor before you make a final decision. If you must receive hormone therapy prior to the frozen embryo transfer, your breastmilk supply may decrease and supplementation may be necessary.  While breastfeeding is NOT contraindicated during pregnancy, theoretically albeit unlikely, nipple stimulation can cause uterine contractions that may interfere with the success of the FET.

Cow's milk is not recommended until one year of age.  If you decide to discontinue breastfeeding before one year, you may want to express and store breastmilk now for later use.  Your baby's doctor can recommend a variety of formulas. In addition, you might see if Nathan would accept a cup rather than a bottle.  Finally, let someone other than you offer the cup.

How can I relieve engorgement?

I am undergoing emergency treatments which require that I not nurse my son for 48 hours every ten days.  In light of this I decided to wean, but had to go "cold-turkey" due to the urgency of the treatment. My son is doing great, actually sleeping more soundly and doesn't seem to miss it at all. However, I am still very painfully engorged after 6 days.  How long will this last?  How can I relieve some of the pressure/pain?





It is very important that you express small amounts of breastmilk to relieve the engorgement.  Unrelieved engorgement can lead to a breast infection (mastitis).  You can either hand express or you can use a breast pump (manual, battery-operated, or electric). Express just enough milk to relieve the pain and soften the breasts.  If you express large amounts of milk, you will signal the breasts to make more milk.  In between expressions, put ice on the breasts to reduce the swelling.  Bags of frozen peas wrapped in a cool washcloth work well.  Continue to express small amounts of milk as often as needed to prevent pain and relieve engorgement.  After 1-3 days your milk production will decrease and you will need to express less often. Expect some milk production for 4-6 weeks.

Can I give my older kids breastmilk?

I've heard that colostrum is very healthy for all humans.  Is this true as I'm still lactating a lot.  I pump almost 2 liters extra than my baby can drink per day of rich milk.  My other kids are older, almost teens, (growing like weeds).  Is it OK to feed them my milk on a daily basis?  Is it good for them too?





Human milk certainly provides substantial nutrition for all individuals regardless of their age.  However, healthy teens that are "growing like weeds" do not need the immunological protection that is so important to immature babies and young children.  It is OK to feed human milk to your older children but it should not be used as a substitute for a variety of foods that are essential to a healthy diet.

Baby not content - how can I improve our
nursing relationship?

Our nursing relationship has always been a battle during the day.  My son was colicky for the first couple months, so I thought it would improve as the colic did, but it hasn't changed much.  He nurses for about 5, sometimes 10 minutes with frequent interruptions for burps, cries, etc. He doesn't seem happy or content during our nursing sessions, and I know I'm not!  It is anything but relaxing to either one of us.  He nurses more calmly at night, so I have tried to recreate this environment during his day nursings, but it hasn't helped.  His weight gain has been good, so he must be getting enough, but I'd like to improve our nursing relationship, if it is possible at this late date.  Thank you





Zachary is certainly growing well!  Watch him closely during the day for early signs of hunger or light sleep and feed him before he becomes fussy or has a chance to cry.  You could also try to breastfeed on only one breast at a feeding in an effort to avoid interruptions. The result would be a low volume, high fat feed.  Finally, you might check his gums to see if he is teething.  Swollen gums can make breastfeeding painful and may explain his yo-yo action at the breast. Once the teeth break through the surface the babies usually settle down for feedings.

Breastmilk has bluish tint - is this normal?

Lately, I have noticed that sometimes my breastmilk has a bluish hue.  Is this normal?  I pump three times a day, and breastfeed at night.





Yes.  Mature milk has two parts.  The first part, the foremilk, has a watery, blue appearance.  The second part, the hindmilk, has a creamy, yellow appearance.  Kai's weight gain certainly appears adequate, which is the best indication that your breastmilk is all that your baby needs.





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