First up, gentian violet. This is renowned for its quick-acting slaughter of all things fungal, and it’s often recommended in crunchy circles. Whereas most yeast treatments take at least two weeks, this takes about three days. The one big drawback is that this stuff is seriously PURPLE and stains everything it touches. (That’s my daughter with a purple mouth, purple thumb, and slightly purple pajamas thanks to GV.)
Want to guess where gentian violet comes from? Nope, it’s not extracted from organically grown violets. Nor from gentian flowers. It’s an extract of coal tar. It was first used as a dye, but then users noticed when they used it for gram staining microscope slides, it killed all the wee beasties they were trying to look at. (And yes, I find it a bit hilarious that there are people who decry mineral oil use on the skin, but who happily slather the insides of their infants’ mouths with extract of coal tar.)
The other potential risks of gentian violet are mouth ulcers and a possible increased risk of cancer. But that’s based on a study of ingestion of large amounts by mice. Honestly, if I had it to do again, I would still use gentian violet for nipple yeast.
Next big natural cure: grapefruit seed extract (GSE). Again, this seems to be a pretty powerful antimicrobial agent. There is research showing that its efficacy is comparable to that of bleach in killing microorganisms. And because it’s derived from grapefruit, a lot of moms feel more comfortable using it on their nipples and in their infants’ mouths. But that’s where we need to back up the truck – the reason this stuff is so powerful is that it is either contaminated with or nearly chemically identical to well-known antimicrobial chemicals Triclosan, benzethonium chloride, and benzalkonium chloride. Since those last two are such a pain to type and so similar, I’m going to give them a cute nickname like they’re a celebrity couple: B-chlor. One study found some commercial GSE preparations contained Triclosan. The others typically find the spectrometry is pinging for B-chlor.
The main manufacturer of GSE, Nutriteam, Inc., maintains that their product is not contaminated with B-chlor. They say their GSE is just similar to B-chlor, so it confuses the spectrometer. And well, I kind of believe them. My conclusion is that their product isn’t contaminated. It’s just that it is for all intents and purposes B-chlor. I don’t know how B-chlor is typically manufactured, but I suspect you can make it using grapefruit as a raw material. And Nutriteam themselves call GSE a “quaternary compound” (just like B-chlor is), and describe a manufacturing process that sounds pretty industrial and non-crunchy. It sounds like they’re doing pretty typical chemical synthesis to me. And they wind up with a substance that tests and works just like B-chlor, only they call it a dietary supplement so they don’t really have to comply with any regulations, and they slap a label on it that makes it sound like something natural, not a “chemical” or gods forbid, a “toxin.”
Now, B-chlor isn’t actually evil, necessarily. It’s used as a preservative in cosmetics and in anti-bacterial wipes. Hell, if you’ve ever given a urine sample, you have probably smeared B-chlor all over your naughty bits. And since many people have used GSE without ill effects (beyond a bitter taste and the possibility of dry, peely skin), I wouldn’t be averse to using it myself if I ever got nipple yeast again. I really don’t like that the manufacturers are getting away with fooling people, but look at my previous yeast post - it feels like rubbing your nipples with broken glass. For me, I’d hold my nose and use GSE since it makes that go away – quickly, for both me and my nursling, without having to get a prescription and explain to the doctor why Nystatin doesn’t work and how much Fluconazole you really need to prescribe, and so on. But I do think moms deserve to know the real story before they decide whether to use it.
So there you go, two wildly popular crunchy alternative yeast treatments, that aren’t really that crunchy. But I’d still use them!
Another mistake many doctors make is treating only one half of the nursing dyad. The standard of care is to treat mother and baby whenever one shows symptoms of candidiasis. Otherwise, one is constantly passing a new load of yeast to the other, despite treatment.
So what are doctors going to prescribe for this treatment? Basically, there’s Nystatin, azole creams, fluconazole, and All Purpose Nipple Ointment.