Nipple Thrush

Well, here goes... my entry to the blogging world with a post on the small wisdom I gained through having nipple thrush. I will be happy if this helps just one other woman as it was a painful experience.

Important: This my story and not a substitute for professional advice. Professionals who may be of assistance include lactation consultant, naturopath, pharmacist and GP.

Diagnosis of nipple thrush is difficult. Before you look for solutions to thrush as a source of nipple pain, it is a good idea to get professional help from a lactation consultant. She will be able to check and assist with breastfeeding generally as well as helping work out if you actually have nipple thrush (rather than attachment or other problems). That being said, be aware that there are people, including health professionals, who have not heard of nipple thrush or who won’t believe that you have it.

Websites you should read

• Better Health Channel information on nipple problems
• Candida Protocol
• Royal Women’s Hospital nipple thrush treatment guidelines

The approach
Nipple thrush can be excruciating; it caused me to wail through many feeds. Although it is not so painful for some, others, like me, find even having a shower painful. This can become a threat to ongoing breastfeeding (and therefore the baby’s health) so must be attended to with urgency and diligence. In my (limited) experience, successful resolution involves understanding the problem and attacking it from many angles at once.

It is possible and likely that the fungal infection is present in more places than just your nipples. It is a good idea to treat all possible infections at once or you risk re-infection after treatment.

Prevention is better than cure
This is probably too late to help if you are reading this for treatment ideas but if it is possible to avoid taking antibiotics during birth or while breastfeeding, that will help avoid thrush in the first place. This is one factor to consider when deciding whether or not to be tested for Streptococcus B infection in late pregnancy.

Immune system
My primary approach was to strengthen my body so that it could fight the infection itself and regain balance. I saw a naturopath for assistance in this and started taking a range of vitamins and minerals specific to my needs as well as breastfeeding-safe herbal remedies. This included immune boosters and pau d’arco which is an anti-fungal bark extract. I got as much sleep as possible and accepted any offers of help to reduce my load including having family and friends cook for us. Getting enough sunshine is also really important in winter to ensure you have enough Vitamin D and this helps with mental health also.

Candida (the fungus that causes thrush) is naturally present in the body and thrush occurs when it flourishes beyond normal levels. Restoring balance in the body’s gut flora (microorganisms in the digestive tract) is crucial to recovery. To help this process along it is highly beneficial to take ‘SB flor + inulin’ which is what the ‘good’ flora in your gut like to eat. You can take probiotics also but apparently it is much more effective to ‘feed’ the good gut flora rather than just putting more of them in. If you want to take probiotics, forget yoghurt etc and buy the capsules available from chemists and health food stores.


Diet
Candida thrives on sugar so it is helpful to reduce the amount of sugar available to it in your body. An anti-Candida diet involves avoiding foods containing sugar (including fruit), grains, dairy and yeast products. Get advice from a naturopath for more specific information and assistance, particularly if you are not familiar with dietary restrictions. This can be a hard diet to manage if you are not used to it so do some meal planning and go easy on yourself. You only need to follow it for a month or two or three so don’t worry if your meals get repetitive for a bit. I don’t normally eat much meat but found I needed to eat more in order to stick to the diet.

Breakfast ideas: Eggs OR quinoa puffs (or cooked quinoa flakes), shredded coconut, pepitas, sunflower seeds, whole bean soy milk, flaxseed oil.

Lunch ideas: this is the tough one, either eat dinner leftovers or cut a few corners (I ate a few corn thins). I ate quinoa-based bread (available from Deeks Bakery if you live in Canberra), hommous, boiled eggs, ham and lettuce.

Dinner ideas:
• Red/green curry or laksa with mung bean noodles, coconut milk and fish sauce and any of the following: organic chicken, greens, mushrooms, carrot, capsicum. Top with coriander, deep fried shallots and lime juice.
• Kangaroo with vegies (except potato and onion) or salad with good oils (eg walnut) and sesame seeds
• Dhal or Indian curry with quinoa
• Fish and vegies
• Egg meal such as omelette
• Soup such as: pumpkin, chicken, vegies, ham and pea. Add lentils or quinoa to bulk it out.
• Amaranth ‘risotto’ or substitute amaranth for quinoa in any of the above for some variety.

Hygiene
There is no point getting rid of the thrush only to be re-infected so I took a number of actions to prevent this from happening. I made sure the laundry was done on a hot wash or ironed the following clothes: my tops, singlets and undies; face washers; nappies, and; anything else that might touch my nipples or my baby’s bottom. You may also want to use the commercially available solutions in your washing machine and make sure you hang clothes outside to get UV from the sun.

Treatments – nipples
Topical application of some kind of anti-fungal seems important, you just have to be cautious to ensure nothing inappropriate is put there and then consumed by your baby. I used the oral solution (nystatin) that I was using in my baby’s mouth to start with (bit messy and sticky as it was never intended for topical application!) and later used gentian violet. Gentian violet is not as messy as they say and seemed to work well. It is not much fun having a baby with a purple mouth but you only use it for a week. See the gentian violet use guidelines.

Treatments – baby mouth
The baby’s mouth can be infected so it is important to treat it at the same time as treating your breasts. There are a number of options, talk to a knowledgeable pharmacist.

Treatments – baby bottom
As with the baby’s mouth, their bottom can be infected and there are a number of options for treatment from the pharmacy. I stumbled on pau d’arco lotion at my local health food store which worked well and I have found it effective ever since on the rare occasions my baby gets nappy rash.


Treatments – vagina
As with the baby’s mouth and bottom, you are quite likely to have vaginal thrush and there are a number of antifungal options for treatment (oral and topical) from the pharmacy. Take care also that your sexual partner does not also get infected and/or re-infect you.

Note that if you take antifungals, make sure the pharmacist understands that it is for nipple thrush and what that entails. I was given a single dose of fluconazole which is designed for vaginal thrush. I think helped but probably would have been better if I had taken several tablets over a period of days as indicated in the Royal Women’s Hospital guidelines.

Large Hadron Collider

I don't usually post links to stuff, but this is too cool.

Blerpl

For those of you who have had to listen to me go on about brain stuff:


After spending a year in mothballs, the learning algorithm I developed last year might finally see the light of day. I've started blogging about it on my other blog, Sparse Coherence.

Photos: New Zealand hiking trip

Sal and I spent three weeks in March hiking on the South Island. We loved it, and it was a great break between living in Melbourne and moving to Canberra. I've finally got some photos online.

Cockroaches can't read

When you buy a house having seen only the photos on the web, there are bound to be a few surprises. One was that the garage is fitted with a Controll-A-Door, which we soon found out hasn't worked for years. Yesterday I took the cover off, and I think I've found the culprit.

For the electronically inclined, just above the roach's head you can make out the track that was vaporised, and the scar on the PCB left by the arcing between active and neutral. The damaged track carried neutral. Should be an easy repair with a jumper wire and a new fuse, but I'll be standing well back for the smoke test.

Banana sour cream cake with chocolate frosting

I just made this. I've come to cooking / baking relatively late in life, and I'm enjoying it.

Apology

We went to Fed Square this morning to watch the apology. The place was packed, and we only just managed a spot where we could see the big screen. This is what we saw:

I'd heard that the wording of the apology had been published and that it was succinct, and so I was expecting that everyone would gather for a few minutes, hear it, and head off.

Everyone stayed for a full hour. Rudd followed the apology itself with an excellent speech. There were several bursts of applause and celebration, and there was a real sense that this was an important occasion. The crowd assembled was unanimously respectful and supportive.

Nelson's response was less impressive, but I won't dwell on that. I still left feeling that something significant has actually taken place. A little taste of justice and dignity.

Walk Report: Genoa River

Coopracambra National Park is in the Eastern corner of Victoria, where the Monaro Highway crosses the border into NSW. Like the Parks page says, it's remote and largely undisturbed. We spent five days off track there between Boxing Day and New Years, including two days walking down the Genoa River, and enjoyed ourselves thoroughly. The walk was made up based on topo maps alone; we were well rewarded for staying away from the few tracks that exist in the park. We didn't encounter anyone until day three, when we passed nearby the Yambulla Peak track.

Progress along rivers and creeks is slow, we averaged about 1km/hr, but that's really where much of the best scenery (and all the swimming) is to be had. Make sure your packliner really is waterproof, and be prepared to dog-paddle with the pack floating loosely on your shoulders in a couple of places. Mostly the water was mid-thigh or lower. Forget walking along the banks - you're either in the water, rock-hopping, or dodging scrub on a spur.

When away from the water it is definitely worth staying right on top of the spur-lines; even there it gets quite slow and scrubby in places, but we always found it passable. Gaiters and zip-off longs are the go, so that you have the option for knee protection - it's scratchy stuff.

We didn't boil or treat any of the water on the walk, and I was fine - but the others experienced some gastro in the 48hrs since we left. It's hard to know which part of the park the bad water came from, as I drank what they drank, and all the catchments certainly looked good on the map. But the badness is likely at or near Beehive Falls, as that's where we finished.

This is certainly somewhere that you'll want to be self-sufficient. Don't expect facilities or mobile phone coverage. Do expect to see some snakes - gaiter up. You'll also attract plenty of interest from biting March flies and mozzies, we were grateful for the loan of a mozzie net to hang under our tarp.

Here are the photos. There would be more if I had a waterproof camera, so you'll just have to believe me about the best bits of scenery. There's a fantastic variety of rocks poking out of the river bed, and some imposing cliffs rising above the waters edge. I suggest visiting the spots on the river indicated on the map as having steep sides - and remember, those are 20m contour intervals.

I look for some variety in a walk, and the contrast between walking the ridgelines and the watercourses was a real highlight here. We were lucky to have significant rain in the week before we went, but I get the impression this is a rewarding place to visit at any time of year.

Please stay lost

On second thoughts, eat the grass. Keep moving, walk down the scrubby gully into the overgrown creek, and if you should hear an aircraft approaching, hide under some bark and avoid being spotted. Please. At least stay out of sight long enough for the searchers to get out of their vehicles and do some searching.

This is a photo of the helicopter I didn't get a ride in yesterday. We were to search an inaccessible section of King River between Pineapple Flat and Lake William Hovell, and there was some talk of winching in search teams. Now that would have been cool. But instead the lost guy got the free winch and heli ride, and we turned around and drove home. Again.

Story in the Oz.

Walk Report: Northern Prom

Yesterday I returned home after a great walk in the northern section of the Prom over the Melbourne Cup four-day long weekend, with Cam and Michelle. I brought back some photos, and some suggestions for anyone planning a visit.

Wilsons Promontory is of course Victoria's best known and most visited national park. I caught the overnight hiking bug there on a three-day loop in 2002, and have been back for several trips in the southern section since. But I'd never previously walked in the less visited northern section, a declared wilderness zone. Water sources there are less reliable, and track maintenance is limited to what walkers contribute with their feet.

Get the topo map. The track is pretty much as marked, except at Three Mile Point where it goes over the saddle rather than around the headland.

Much of the track looks like this:

Follow the footpad and the marking tape. Be prepared to retrace your steps a little when you realise that you've been following a wombat track or other errant walkers - it's worth going back to find the real track. Fallen trees (especially after the wild storm this weekend) will send you in the wrong direction. When in doubt continue a little to see if it becomes more clear, but don't throw your pack through the hedge to create a new track. Contrary to hearsay from other hikers we met, there is a footpad all the way and it can be found, frequently by feel and some experimentation. Our party of three meant that we could explore two forks with one person staying at the last known point on the track.

Go anticlockwise if the campsites are available in that order, so that you make the metre-deep crossings of Chinaman Creek on the last day. Leave some dry socks in the car.

I can't offer much advice regarding water as the storm provided plenty on our trip. Lower Barry Creek looked like an aqueduct when we passed through, yet it's not even shown as a water source on the map. But when we arrived at Five Mile before the storm, Cam had to push a fair way up in the scrub opposite the campsite before he found a good trickle to fill from. The water had plenty of tannins but seemed clean and I drank it untreated without problem.

If you can book two nights at Tin Mine Cove, it's a beautiful sheltered beach with opportunities for off-track exploration to Mt Singapore. A couple of mozzie coils might come in handy.

This was a really enjoyable, quite challenging walk, and if you like a bit of navigation and the feeling of remoteness then it's a great place to go - especially with a pair of superstars like Cam and Michelle.

More photos

Germany, Sweden, USA

Yay! More pretty pictures from Germany, Sweden and USA.

Alice und Michael

Print-quality photos and a slideshow are now online.

A big train set

This post is about my first of impressions of Germany. Well technically I've been here before when I was five, but I'm not counting that.

You know how in flight simulators there's always at least one hot-air balloon floating around somewhere near the camera viewpoint? I always assumed that was because it makes the scene look cool; but now I'm not so sure. My first morning here, and I've already seen at least three.

You know how model train layouts always look too clean, tidy and well-planned to be real? I always assumed those were just the inevitable unrealities of the model train world; but now I'm not so sure. I've felt all day like I'm in a Märklin brochure, or a Lego town.

There's more I'd like to say, but the 8hr timezone shift is making me go cross-eyed while trying to type, so I'll just leave you with some photos. Suffice to say, very happy to be here and feeling very well looked after.

Strip that Willow

Yes, that's a full set in our tiny appartment - five couples, counting Sal and me. When asked to run a bushdance for some Aussie flavour at Alice and Michael's wedding in Germany, we thought it only proper to stage a practice run. Our dhal-night friends, being the good sports and get-up-and-into-it movers that they are, kindly obliged us; Sal did a great job of instructing and calling, and a good time was had by all. I was too busy stripping (the willow), polkaing with both heel and toe, waving at Bondi and, um, drongoing to get many good shots, but you get the idea.

Checkpoint 3

One day the checkpoint came to me! And then Merv turned up! You can just make him out in the photo.

Very little thick or prickly vegetation

Next time I see those words in the description of a rogaine, I think I'll wear my gaiters all the same. Here's a "before and after" shot of my socks, and the thorn that I found still buried in the back of my knee 24hrs after the event. But don't get me wrong, we had plenty of fun on the course.

A day in preparation

What should one do after spending a day preparing for a dinner party? Why, spend another day making a movie about it of course!

Watch the movie

Stay put. Do not eat the grass.

Just before Easter I got my first BSAR callout since signing up about a year ago. It turned out to be a great dry-run - we did everything except actually searching. The timeline went something like this: (times are very rough)

• 4pm: SMS from BSAR alerting of the possible search. Commence packing gear/food.
  
• 9pm: Call from VRA, the search is on. I'm all set.
• 4am: Sal drops me at the police bus in Brunswick.
• 8am: We arrive on site, divide into teams of three.
• 9am: Search briefing; our team gets a spur that looks much nicer than the various scrubby gullies assigned to the other teams.
• 10am: 4WD drops us at the start of our walk in farmland near the creek.
• 10:10: Call received - search subject has been found in good condition.

So did we contribute to the search? Well, yes - it's a numbers game. The more search area you can cover, the more likely the subject is to be found. My chances of ever being in a search party that finds the subject are vanishingly small, and that's fine - it's still an interesting and worthwhile activity.

Anyway the main point of this post is to offer some advice on what to do if you become lost in the bush, especially if someone knows you're out there:

1. Stay put.
2. Do not eat grass.

William must have mentioned on his return that he'd had a nibble of some watercress while wandering around, and a bright spark at The Age took this as license to report that his survival was made possible only by eating grass. Yeah good one. This is true in much the same way that the searchers survived only by eating M&Ms.

The energy (if any) gained by eating watercress was not nearly sufficient to make up for the energy he spent walking around unwittingly dodging the police. It's unclear just how many times they must have crossed paths on the day before we were called out. A search operates by eliminating areas in order of likelihood. William was found by a vehicle that was passing along a track that had already been eliminated early in the search.

Of course everyone was very happy to see him found and in such good shape, and nobody begrudges that he might have made the search team's job easier.

By the way, if for some reason you are lost and you have no reason to believe that anyone will come looking for you any time soon, then you will have to get yourself out. Don't panic, your chances are probably really good unless you happen to be standing in the snow/rain/creek in your jeans and T-shirt. Make a plan to walk towards an object that is shaped like a line, like the road or the ocean. But nobody reading this blog would ever put themselves in that situation.

More reports on the search.

Shiny happy brass

Click the image and look closely at the full-size version for a while.

I made this image of the bell of a tuba while we were waiting for Michael's band to do their thing at the Australian Nationals, they came a very commendable 3rd in B-grade as it turns out. (And if I understand the tallies correctly, an extra 2 points in the march could have made them equal-first!)

Anyway I just like the bell's layers of reflections of itself, and the band lined up on the right. How many Bens are there in the image?

And a couple more from the day:

Chuck's blog

Chuck's blog Lounge of the Lab Lemming is excellent, I wish I'd known earlier that he had one. My blog won't be nearly as intelligent or well-written, so I recommend you go read his instead.

My congratulations to Mr and Mrs Lemming - I can't wait to meet the new arrival, and I'm very jealous that Sal picked the right weekend to be in Canberra. I look forward to more photos, and to Chuck's musings on parenthood.