Recommended dose of Fluconazole for ductal candidiasis (if it even exists, but that’s another story) is 200 – 400 mg loading dose, then 100 – 2oo mg od for 2 – 3 weeks. (Merewood A and Philipp B, Breastfeeding: conditions and diseases. A reference guide.)
Mastitis should be treated for 10 – 14 days as shorter antibiotic courses increase relapse risk. Fluclox 500 mg or erythromycin 250 – 500 mg are the first-line antibiotics, cef 500 mg the second and co-amox 625 the third.
This is a useful resource for looking up safety of medications in lactation.
Danger signs indicating insufficient intake include:
- Under 2 weeks – loss of >10% body weight, or lack of any yellow stools in first week.
- 2 weeks – weight not back to birthweight
- 2 weeks to 3 months – weight gain <20 g/day (note that normal is 30 g/day), or weight loss.
- >3 months – flat or decelerating growth curve
- No urine output for 24 hours
- Clinical signs of dehydration
(From the BMJ learning module)