What is Thrush?

Thrush/nipple yeast and vaginal yeast are caused by the one-celled organism, Candida albicans. It is a fungus that thrives in moist, dark environments (like the nipples, milk ducts, mother’s vagina, baby’s mouth and/or baby’s diaper area). The use of antibiotics by mom or baby is a contributing factor in the occurrence of yeast. A cracked or sore nipple can also contribute to the occurrence of  yeast.

A consultation with your healthcare provider is  important. Here are a few questions to help you determine if you or your baby has a yeast overgrowth. If you answer yes to one or more of these, you may have thrush.

• Have you noticed white spots/patches in your baby’s mouth?
• Does your baby have a bright red, pimply diaper rash?
• Is your baby gassy, fussy or not nursing well due to oral thrush?
• Is the area around your nipple pink, red, itchy, flaky or shiny?
• Do you feel a burning sensation on your nipples either during or between feedings?
• Do you have a cracked nipple that won’t heal?
• Do you feel shooting pains in your breast (different from the sensation of let-down)? Some women describe the feeling as “a piece of glass” or “stabbing.”
• Have you or your baby completed a recent course of antibiotic treatment?
• Did you have a cesarean birth or were you diagnosed with a vaginal Strep-B infection?

**Note: It is rare for a mom to have a red rash or white spots on her nipples with a nipple yeast infection.**

Here are some common treatments for thrush. It is very important that both mom and baby are treated at the same time, even if only one of them show signs of yeast. Yeast/thrush is highly contagious, and if not treated together, they will keep passing it back and forth to each other. Be sure to continue treatment for at least 2 WEEKS after the signs of Thrush/yeast have gone away.

• Your healthcare provider can prescribe a prescription of Nystatin for you and baby – a cream for mom to use on her nipples and oral liquid for baby. Make a run to the store for yogurt containing live, active cultures (especially acidophilus). The yogurt cultures (acidophilus) will help get rid of the yeast. If your baby is old enough, you can offer him some too.

Acidophilus supplements. This does the same thing as the yogurt. You should be able to find acidophilus in the health food section of your grocery store/pharmacy or at a natural foods store. This can also be crushed (or, if you have the caplets, opened) and sprinkled directly on your nipples. If you wish, you can do this just prior to feeding so your baby gets a dose of acidophilus, too. A daily probiotic, in tablet, capsule or liquid form, is a good way to keep your normal flora from overgrowing. Taken on a daily basis should be a part of your healthy lifestyle behavior.

Gentian Violet. You should be able to find this in your local health food/natural foods store or in the natural food or vitamin section of your store. Using a clean cotton swab, rub some on each nipple. In order to treat baby, also, it works best to put some on your nipple and then latch baby on to nurse. It will coat baby’s mouth while he is nursing. It is a bit messy, so you’ll want to make sure you are wearing clothes you won’t mind getting purple stains on. This should only be used for 3 days.

Grapefruit Seed Extract. (not grape seed extract),  ACTIVE INGREDIENT MUST BE “CITRICIDAL”), 250 mg (usually 2 tablets) three or four times a day orally (taken by the mother), seems to work well in many cases. If preferred, the liquid extract can be taken orally, 5 drops in water three times per day (though this is not as effective). Oral GSE can be used before trying fluconazole, instead of fluconazole or in addition to fluconazole in resistant cases.

Dr. Newman’s All Purpose Nipple Ointment (from his Candida protocol handout): Mupirocin 2% ointment (15 grams), Betamethasone 0.1% ointment (15 grams), and micona-zole powder so that the final concentration is 2% miconazole. This combination gives a total volume of just more than 30 grams. This cream requires a prescription sent to your local compounding pharmacy. The combination is applied sparingly after each feeding (except the feeding when the mother uses gentian violet). “Sparingly” means that the nipple and areola will shine but you won’t be able to see the ointment. Do not wash or wipe it off, even if the pharmacist asks you to. I used to use nystatin ointment or miconazole cream (15 grams) as part of the mixture, and these work well enough, but I believe the use of powdered miconazole (or even clotrimazole powder) gives better results. These ointments can be used for any cause of nipple soreness (“all purpose nipple ointments”), not just for Candida (yeast). Use the ointment until you are pain free and then decrease frequency over a week or two until stopped. If you are not having less pain after 3 or 4 days of use, or if you need to be using it for longer than two or three weeks to keep pain free, get help or advice.

Vinegar Wash: 1-cup water and 1 tablespoon of vinegar. Use at least 4 times per day, after nursing. Use a clean cotton ball/swab to apply every time and let air-dry.

Cut back on your sugar intake. Yeast also loves sugar, so the less that is in your body, the less the yeast has to thrive on.

Sterilize anything that goes into your baby’s mouth or has contact with your nipples. This is necessary to kill the yeast that is on those items and prevent it from reinfecting you. This includes any toys, pacifiers, bottle nipples, breast pump parts and your bras.

Wear disposable breast pads. Change them with each nursing and just toss them out. This way, you’re not sterilizing your bra every night.

• Some moms have found swimming in a chlorinated pool to clear up their nipple yeast very quickly.

Diflucan (generic: fluconazole) is a prescription medicine that is commonly used to treat vaginal yeast infections. It has been shown to be effective against nipple yeast/thrush, especially when the yeast has survived all other treatments or it is a ductal yeast infection (meaning it is in your milk ducts, not just in the nipple area). The dosage for proper treatment is: 400mg loading dose on day one, then 200 mg per day for 13-28 days after that. Again, your baby should be treated at the same time you are being treated.

Be sure to keep in contact with your healthcare provider and lactation consultant on your treatment regimen and if the symptoms are improving.

presented by Angel J. Miller, MSN, CNM



http://www.tinyurl.com/yztozrl-Dr. Newman’s candida protocol



Happy Mommy, Happy Baby! The Benefits of Prenatal Massage

If you’re a mother-to-be and researching Prenatal Massage, you’ve probably asked
the question “is it safe for my baby?” This is a question you should be asking, and as
a practitioner of Prenatal Massage for many years, a receiver of Prenatal Massage, and a

mother of two healthy girls, I can attest to the general safety and magic this service
can add to your pregnancy. However, Prenatal Massage is not always recommended, if your
having a high-risk pregnancy or any other complications, you may want to check with your
doctor before booking your appointment. For those looking to add this service to their

Prenatal Massage can:pregnant belly

*Increase levels of the “feel good” hormones Serotonin and Dopamine

*Decrease back, hip, and leg pain
*Decrease levels of the stress hormone Norepinephrine
*Decrease levels of Cortisol (an indicator of stress)
*Dramatically improve your mood
*Improve sleep
*Improve energy levels

As your baby grows you can expect many hormonal and physiologic changes to occur. Prrogesterone levels increase during pregnancy which cause a loosening of ligaments and joints throughout the body. As baby grows, a woman’s entire posture changes to accommodate (Ouch!). All of these factors can cause discomfort and stress. Disruption of regular sleep and elevated hormones cause your emotions to stir easily, compounding these challenges. Prenatal Massage can help relieve the emotional strain as well as the physical pain by combining calm relaxation with gentle therapeutic bodywork to sooth you and your baby. In other words, a happy mom makes a happy baby!

During a Prenatal Massage Therapy session you can expect some changes from your
regular massage. This massage uses multiple cushions and bolsters to ensure that Mommy is
comfortable in any position. Some practitioners have you lay on your sides, while others
use cushions that allow you to lay face down. Mommy’s position should be what she is most
comfortable with. Every mom has their own preference, and you should never hesitate to
let your Therapist know your preferences. All massage strokes should encourage
circulation towards the heart and there should never be direct pressure applied to your
lower legs or ankles. Although most massage training institutions teach massage therapy
for women who are pregnant, it is best to find a massage therapist who is certified in
Prenatal Massage. Your therapist should always ask you specific questions about your
pregnancy and make sure all of your issues are addressed. If you are searching for
something to enhance your experience and help you endure, Prenatal Massage is a great way
to prepare, stay positive, and healthy throughout your pregnancy.

Blog by Dana Durand, NCTMB, Licensed Massage Therapist


This entry was posted on November 1, 2015, in Pregnancy.

TIME – the Most Precious Commodity of All

breastfeeding momMost mothers are stressed when they have a new baby. I absolutely remember how tiring it is to be a mother – and especially when you’re a breastfeeding mother. Being tired is on my mind right now, because in the midst of working with a new breastfeeding mother of a six-day-old, she flat-out told me that, “this breastfeeding thing is taking way too much of my time.” I was left flabbergasted and flap-jawed. What I wanted to say and what I did say were two very different things. What I wanted to say was “Well, what were you expecting? Did you think you were going to drop the baby in the umbrella stand on the way in and out of your front door?” What I actually said is “Tell me how I can help you.”

The mom went on to explain that nursing every two hours was beginning to grate on her nerves. I went on to explain that babies had tummies the size of golf balls and that breast milk was a “perfect food” that made it digest and move through the stomach very rapidly. I quoted how each DROP of colostrum had 3 million cells (the majority being immune cells). Breastfeeding is as much nurturing as nourishing (hoping the old adage would help). I also described cluster feeding as being analogous to a camel getting ready to cross the desert; feed, feed, feed and then you get the big sleep (maybe 4-5 hours max). In my first book “Start Here; Breastfeeding and Infant Care with Humor and Common Sense” I tried to call the hours between 6-10PM the “arsenic hours,” but the publisher opted for something safer like “the witching hours.” I guess that “every hour on the hour” cluster thing is what put this new mother “over the edge.”

So, here are some suggestions I’ve come up with to help you save time during your busy breastfeeding days.

  • If you have an exceptionally sleepy baby (or just have to get the show on the road once in a while), I find that you can feed on one side while you simultaneously pump on the other: Tarzan Pumping (at least that’s what I call it). That trick alone can save you up to a half hour per feeding and maximize your milk supply. Your body will react as it you’re feeding twins (because both sides are going at the same time) and perhaps even increase supply a bit. It will also expedite your feeding and have your baby feel as though a bigger, stronger twin was on the other breast helping him or her out. Now you’ll want to feed that milk to your baby at some point (perhaps during cluster feeding time), as when I previously instructed another mom to do this, she was giddy with her new frozen stash; problem was the baby hadn’t gained any weight in a week…whoops; I should have been more clear with my instructions.
  • Anyone who tells you to sleep when the baby sleeps probably doesn’t shower, do laundry, use the bathroom, open the mail or eat; I never understood that suggestion. I mean, that’s the only time you have to do ANYTHING, isn’t it? So, ALLOWING others to do things for you will help put time back in your day. You shouldn’t feel as though you’re not a good mother if you don’t do everything and do it well (do as I say, not as I do/did). I remember 28 years ago how I came creeping out of my house to get the mail and was spotted by my neighbor. She promptly sent her “nanny” over to my house with instructions to “help that poor woman out.” Problem is that I wouldn’t let the well-meaning nanny in! As I look back on it, I was afraid that I’d be found out; that I’d be “exposed” and my neighbor would know how I wasn’t really holding things together as a mother “should.” In my experience, many mothers feel that same way. They’re overwhelmed but think that they’re the only mother experiencing that. I’m here to tell you that MOST mothers feel overwhelmed in the beginning and if they tell you otherwise, I’d be wary.
  • Remember the saying “time is fleeting,” so are these stages!  Many times these cluster feeds will pass quickly and after a couple days you’ll have an entirely new baby.  It’s important to keep in mind that babies patterns change quickly and you won’t always be feeding around the clock. 

When I heard this mother complaining about time, as I think more about it, I’m suspicious there might be something else going on. Is she depressed? Is she lonely and needs to get out of the house for companionship, does she simply have cabin-fever, or are her expectations unrealistic as to how much time infants take out of a mothers day? What do you think?

Blog written by  Kathleen F. McCue, DNP, FNP-BC, IBCLC-RLC, 

Owner of Metropolitan Breastfeeding

Building a Strong Foundation for Your Pregnancy

Contemplating pregnancy?  Nutritional and optimal health should be priority number one!  Women contemplating pregnancy must keep in mind that healthy eating habits and healthy lifestyle behaviors should be established before pregnancy to make sure proper nutrient levels for early embryo development and growth.

Eating a balanced diet that includes the proper amount servings of protein, grains, fruit, and vegetables is key. Protein is essential to the very foundation of your baby’s growth. Eating enough protein ensures that your little one, from the very beginning, is getting adequate food stores to support cell growth and blood production.  Regular exercise should also be incorporated in your daily routine to prepare your body for the demands of pregnancy. Habits such as drinking or smoking must be avoided to allow for optimal health and development of the child during pregnancy and after birth.  Good habits should  include taking a daily multivitamin or a daily prenatal vitamin.  Even if you are consuming healthy foods daily, you can miss out on key nutrients.  A daily prenatal vitamin — ideally starting three months before conception — can help fill any gaps.  A quality, fast absorbing prenatal vitamin is necessary for all the basic micronutrients needed during pregnancy.eat-well-teaser

Through the course of pregnancy there is an increased need for nutrients and calories to make sure proper fetal growth. The increased need for vitamins and minerals such as folate, calcium and iron is necessary to prevent birth defects, ensure proper bone formation/retention, and to reduce the risks of preeclampsia or anemia. Folic acid intake increases to a daily amount of 800 mcg, calcium to 1200 mg, and iron to 30 mg. Your Vitamin D levels should be checked with your initial prenatal labs to be sure you levels are not insufficient or deficient.  Fetal needs for vitamin D increase during the latter half of pregnancy, when bone growth and ossification are most prominent. Vitamin D travels to the fetus by passive transfer, and the fetus is entirely dependent on maternal stores. Your body needs vitamin D to maintain proper levels of calcium and phosphorus, which help build your baby’s bones and teeth. A vitamin D deficiency during pregnancy can cause growth retardation and skeletal deformities. It may also have an impact on birth weight.  Therefore, maternal status is a direct reflection of fetal nutritional status.

Researchers believe that a vitamin D deficiency during pregnancy can affect bone development and immune function from birth through adulthood.

Blog by Shelia Kirkbride

Announcing a New Baby

smallhandbighandAs a birth doula I frequently hear form my clients about the frequent calls and messages requesting labor updates was challenging. Has the baby arrived yet? What you are still pregnant? Are you feeling contractions?

Even though the family and friends are only trying to show their excitement and concern these questions often times have my clients pulling their hair out and screening their calls. From the receiving side the constant checking in can be  overwhelming and challenging.  As due dates come and go it can be hard to stay relaxed when everyone is reaching out reminding you of your due date.

Here are three of my suggestions to make your labor and recovery time easier.

  1. Chose to either embrace or to not engage in social media. If you share your pregnancy on line you are essentially welcoming everyone to check in on you and offer words of advice.
  2. Set up communication guidelines ahead of time with friends and family.  Either plan a phone call tree or set up a group email message that goes out all at once so that the aunts and uncles don’t think you played favorites.
  3. Post both digitally and print out a birth announcement for your front door. The suggested one below announces the baby and their stats, yet most importantly informs visitors of your needs to recuperate and bond while asking your visitors to pitch in.  The list is editable, so feel free to change it to your needs.  I love this idea as it encourages your visitors to  pitch in and offer a helping hand as you navigate a new chapter in your lives.

We have a NEW baby!


Birthdate and Time:

Weight and length:

Having a baby is hard work! We need your assistance in resting and adjusting in order for our family to bond together.   We appreciate your visit and appreciate it even more by your helping us to complete necessary tasks in this home so that we can continue to heal, bond and learn all about our new baby.

  1. Please do not come in if you are sick or have been around who has been sick. Our baby is precious cargo.
  2. Wash your hands as soon as you come in.
  3. Pick one or more items from the list below as a gift of time and love to our family.  We really appreciate it!
Prepare or arrange a meal Mop or vacuum
Grocery shopping Ask for a task
Clean up the kitchen Walk the dog
Clean the bathroom Take the toddler to the park
Do a load or two of laundry Water the plants, garden, lawn
Take out the trash Ask for a task

Thank you,

The proud parents!

Presented by

Ursula Sabia Sukinik, Owner and CEO


Grief and Self-Care

This blog was originally published (by the author) on Reconceiving Loss in July 2015.

It’s the time in your life when the hardest thing to do is to be selfish. Yet, that is how you might feel in terms of your emotions. The sadness, tears, heaving sobs that are unrelenting threaten to unhinge you. You yearn to stop, but you can’t. Those around you try to offer you comforting words or platitudes. Sometimes they help, but often they don’t. This is what grief can look like, particularly the soul-crushing grief of losing a pregnancy or baby.

Through this grief, you often feel alone. Friends and family don’t seem to understand that one month later, you haven’t “snapped out of it” and “moved on.” Your partner is also at a loss for words or actions that might be comforting as he embraces you for the hundredth time. Perhaps he sees the loss differently. Or maybe more time has passed and you even have another baby, yet you still feel some numbness that this new baby hasn’t been able to fully eclipse.

This is the time when you just want everything to disappear. Or you throw yourself back into your life, willing the everyday motions to undo the feelings. You want to be cared for, but all of the attempts of asking aren’t helpful. Perhaps there are a few people that get it, but you don’t want to burden them. The temporary salve they provided in just talking and listening has worn off, and reaching out seems too hard.

A compounded loss in grief is the temporary loss of your sense of self and the idea that you have a semblance of control in your life. Taking this back and reclaiming you can be important and healing through your grief journey. But how? Taking tiny steps to care for yourself. Yes, take care of yourself.

In the throes of grief, it can be difficult to even get out of bed in the morning and go through your hygiene routine. Even past this phase, doing anything pleasurable can seem like plodding through molasses. Often, grieving mothers fear that if they start to engage in life again, that somehow this means that they are forgetting the baby that died. There might be continued focus on trying to achieve a new pregnancy (from yourself or from those around you) as if this is the answer to healing. Ultimately, at the end of the day, you are your own best resource. You are your own best advocate. To do either, you need strength and perhaps the permission that it is OK to matter. It is OK to indulge. It’s OK to ask for a break and to take charge of your needs.

What might self-care look like? It can be as minimal as taking time to journal, take a bath, go on a walk, or sing. Self-care doesn’t have to cost money (as the previous examples suggest) but it’s also fine if it does. Examples might be: a manicure, massage, a weekend retreat, signing up for a class or learning a new skill.) The only limit is you. And you are the only one who is fully able to care for yourself in the way that feels best.

by  Julie Bindeman, Psy-D, Co-Director of Integrative Therapy of Greater Washington


Best Exercises for Your Pregnancy

Congratulations on your pregnancy! Now you can sit back, relax and put your feet up for the next nine months, right? Not so fast! Attitudes and beliefs about prenatal exercise have drastically changed over the past twenty years. No longer is pregnancy viewed as a time to sit, watch TV and each chocolate. These days, moms can actually maintain and improve their fitness levels while pregnant. And exercise provides many numerous benefits such as a boost in your mood and energy levels, helps you sleep better, helps prevent excess weight gain and increases your stamina and muscle strength. You cannot lose!

Regular exercise during your pregnancy can improve not only your heart health and boost your energy, but improve your overall health. Maintaining a healthy body and healthy weight gain can help reduce common pregnancy complaints and discomforts like lower back pain, fatigue and constipation and can even help with shortening your time during labor by strengthening your endurance.

First, consult your health care provider if it is okay to exercise. If you have been participating in a regular exercise regimen and are having a healthy pregnancy, there should not be a problem continuing with your regimen in moderation. You may have to modify your exercise according to your trimester of pregnancy.

If you have not participated in an exercise regimen three times a week before getting pregnant, do not jump into a new, strenuous activity. Start out with a low-intensity activity and gradually move to a higher activity level.

The best type of exercise during pregnancy:
• Increases your heart rate steadily and improves your heart circulation
• keeps you flexible and limber
• manages your weight gain by burning calories
• prepares your muscles for labor and birth
• won’t cause you to push your body too hard

Research shows that healthy pregnant women who exercise during their pregnancy may have less risk of preterm labor and birth and a shorter labor process, are less likely to need pain relief, and recover from childbirth faster.

Regular, moderate exercise not only gives you a healthier pregnancy, it may give your baby a healthier start. Research shows that when pregnant women exercise, their developing babies have a much lower heart rate. Babies of active moms may also have a healthier birth weight. Experts recommend that you exercise for 30 minutes a day, on most days. Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do not overdo it.

Your pregnancy exercise regimen should strengthen and condition your muscles. Always begin by warming up for five minutes and stretching for five minutes. Following your choice of exercise, finish your regimen with five to ten minutes of gradually slower exercise that ends with gentle stretching.

The safest and most productive activities to perform during your pregnancy are brisk walking, swimming, indoor stationary cycling, prenatal yoga and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until the birth of your baby. Other activities such as jogging can be done in moderation. You might want to choose exercises or activities that do not require great balance or coordination, especially later in your pregnancy.

Use common sense:
• Avoid exercising that involves lying on your stomach or flat on your back after the first trimester of pregnancy.
• Stay well hydrated and drink plenty of fluids before, during and after you exercise.
• Avoid overheating and humidity, especially during the first trimester when the fetus is undergoing its most important growth and development.
• Stop exercising if you feel fatigued, develop persistent pain or experience any vaginal bleeding; check with your healthcare provider if regular contractions occur more than 30 minutes after exercise (possibly a sign of pre-term labor).
• Avoid heavy weightlifting and any activities that require straining.
• Avoid exposure to extremes of air pressure, as in high altitude exercise (unless you’re accustomed to it) or scuba diving.
• Do not increase the intensity of your workout beyond pre-pregnancy intensity level
• Eat small, frequent meals throughout the day. Sedentary pregnant women need about 3,000 calories per day during the second and third trimesters; if you are physically active, your caloric needs will be higher to make up for the calories burned up during your exercise regimen.

Basic exercise guidelines:
• Wear loose-fitting, comfortable clothes, as well as a good support bra
• Choose shoes that are designed for the type of exercise you choose. Proper shoes are your best protection against injury
• Exercise on a flat, level surface to avoid injury
• Finish eating at least one hour before exercising
• Get up slowly and gradually to prevent dizziness
• Never exercise to the point of exhaustion. If you cannot talk normally while exercising, you are probably over exerting yourself, and you should slow down your activity.

Physical changes during your pregnancy will create extra demands on your body. Keeping in mind the changes listed below, remember you need to listen to your body and adjust your activities or exercise regimen as necessary.
• Your developing baby and other internal changes require more oxygen and energy.
• Hormones (relaxin) produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.
• The extra weight and the uneven distribution of your weight alters your center of gravity. The extra weight also puts stress on joints and muscles in the lower back and pelvic area, and makes it easier for you to lose your balance

If you have any medical condition, such as asthma, heart disease, hypertension or diabetes, exercise may not be advisable. Again, consult with your health care provider before beginning any exercise regimen.

Exercise may also be harmful if you have a pregnancy-related condition such as:
• vaginal Bleeding or spotting
• Low placenta (low-lying or placenta previa)
• Threatened or history of recurrent miscarriage
• Previous premature births or history of early labor
• Weak cervix

Talk with your health care provider before beginning any exercise program. Your health care provider can also suggest personal exercise guidelines, based on your medical history.

Stop exercising and consult your healthcare provider if you:
• Feel pain
• Have abdominal, chest, or pelvic pain
• Notice an absence of fetal movement
• Feel faint, dizzy, nauseous, or light-headed
• Feel cold or clammy
• Have vaginal bleeding
• Have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily (when your bag of “water” breaks, also called rupture of the amniotic membrane)
• Notice an irregular or rapid heartbeat
• Have sudden swelling in your ankles, hands, face, or experience calf pain
• Have increased shortness of breath
• Have persistent contractions that continue after rest
• Have difficulty walking

Regular exercise will keep you and your baby healthy while staying fit, and enjoying your pregnancy!

Written by: Angel J. Miller, MSN, CNM, certified nurse-midwife, Midwifery Service Director, Washington, D.C. Area and co-author: Nine Months In ~ Nine Months Out.
Miller, Angel, Kelly, Stacia, Kirkbride, Shelia, Matthews, Corry. Nine Months In ~ Nine Months Out. Sterling, Va. Ironcutter Media, 2011.

This entry was posted on June 22, 2015, in Pregnancy.