“The baby on the left clearly had considerable problems in the early 1-2 weeks but is now thriving, although on a centile lower than the one on which she was born.  The baby on the right has the same start and end points as the baby on the left, but is not really gaining and … Read more…



GPs should feel confident to be able to: •    Promote breastfeeding •    Refer for appropriate skilled help with breastfeeding problems •    Support breastfeeding in discussions with parents •    Act to protect breastfeeding while investigating illness •    Prescribe to protect breastfeeding in treating illness



Essential to treat mum and baby simultaneously, with both surface treatment for both and systemic treatment for mum, at correct dose. Fluconazole is not licensed for breastfeeding women in UK, although it is licensed for treating neonates, babies and children (who would receive a higher dose of Fluconazole directly than a breastfeeding baby would receive … Read more…



• Very unlikely in first 2 weeks, unless there was vaginal thrush at time of birth • Very unlikely unless there has been thrush in either baby, mum or both • Very unlikely unless there has been antibiotic treatment of mum, baby or both



Nipples may look fiery red or blanched, may be itchy, may be extremely sensitive, but may also look entirely normal.Breast tissue may be described as ‘burning, like daggers inside, stabbing’ and the pain usually occurs throughout the feed and may persist for at least 1 hour after the feed.



Thrush in the baby is becoming increasingly common, especially if mum and/or baby have had antibiotics.It is essential to treat mum and baby simultaneously, even if mum has no symptoms, or the baby will not be treated effectively and thrush will keep recurring, and mum’s nipples/breasts may become infected too.Miconazole gel is much more effective … Read more…



•    Continue breastfeeding – mastitis may get much worse, including developing into an abscess, if the mum abruptly stops breastfeeding •    Improving positioning and attachment will help resolve mastitis •    Offering the affected side first, when the baby is more hungry, can help with milk removal •    Expressing and gentle massage are especially important if … Read more…



In early weeks, mastitis is most likely to be caused by ineffective feeding leading to milk stasis and an inflammation reaction.  There may be a bacterial infection, but this is most likely when the nipples are also damaged, and most mastitis is not due to infection.