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The information provided is taken from various reference sources.  It is provided as a guideline.  No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used.  Clinical decisions remain the responsibility of medical and breastfeeding practitioners.  The data presented here is intended to provide some immediate information but cannot replace input from professionals.

Creams and pessaries containing Clotrimazole and oral single dose treatments of fluconazole can be used during breastfeeding as small amounts pass into breastmilk.

Vaginal thrush is experienced by most women on occasions – some more frequently than others.  Symptoms are vaginal itching, irritation, soreness and sometimes a cream-cheesy discharge.  It can make passing urine painful and sex uncomfortable.  Symptoms can occur after a course of antibiotics when all the friendly bacteria as well as the infecting ones are killed off allowing the thrush (Candida) to flourish.  It can also occur if your partner has candida on his penis or after enthusiastic sex (often called honeymoon disease!).  If you have never had thrush before it is advisable to consult a Doctor to confirm the diagnosis.  However, many women self-treat by purchasing products from a community pharmacy.  Many people apply live, plain yoghurt vaginally (often on a tampon) as well as eating it or taking acidophyllis capsules.  Careful hand hygiene prevents spread to other members of the family.  Towels should be kept separate.  Avoiding tight jeans and not wearing tights may be necessary with repeated infections.  Cotton pants can also help to relieve symptoms.

Over the counter products

• Vaginal creams – Clotrimazole. Trade name : Canesten®
• Pessaries – Clotrimazole. Trade name : Canesten®
• Oral treatment – single dose fluconazole 150mg. Trade names: Difflucan®, Canesten Once®, Own Brands

Prescribed products

• Vaginal creams – Clotrimazole (Canesten®), Miconazole,(Gyno-Daktarin®), Econazole (Gyno-Pevaryl®)
• Pessaries Clotrimazole (Canesten®), Miconazole,(Gyno-Daktarin®),Econazole (Gyno-Pevaryl®)
• Oral treatment – single dose fluconazole 150mg. Trade names: Difflucan®, Canesten Once®

All can be used during breastfeeding.

Bibliography

• British National Formulary
• Hale T. W Medications in Mothers Milk
• Jones W Breastfeeding and Medication 2018 Routledge
• Lactmed http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
• Martindale, the Extra Pharmacopia 2007

©Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network Sept 2019