When you hear the phrase “yeast infection,” you likely don’t associate it with breastfeeding. Yet as many moms know, breastfeeding and yeast can combine to cause an unpleasant, painful infection in both Mom and Baby called thrush.
What is Thrush?
“Thrush is a yeast infection in the mouth,” says Dr. Deborah Lehman, a pediatric disease specialist at Cedars-Sinai Medical Center in Los Angeles. Yeast fungus, also known as Candida albicans, thrives in moist, dark areas—so an infant’s mouth is an ideal place for thrush to take up residence.
Babies can get thrush in several ways. Exposure to antibiotics (either by the child or a breastfeeding mother) can cause thrush since the antibiotics kill the friendly flora, or bacteria, found naturally in the human body, allowing the yeast to thrive. Some babies become infected when they make the trip down the birth canal, while others contract thrush from pacifiers and bottle nipples. Babies are susceptible to thrush because “their immune systems are weak and are not fully matured,” explains Dr. Leo Galland, co-author of Superimmunity for Kids).
“Infants can’t tell you what they’re feeling, so [go by] what you see,” recommends Dr. Galland. White patches on the gums and tongue that cannot be scraped off are a telltale sign of thrush (if it’s milk, it can be scraped or wiped off). Other symptoms include fussiness, irritability, and discomfort when eating.
According to Dr. Cathryn Tobin, pediatrician and author of The Parent's Problem Solver, “A mother who has been breastfeeding without pain and develops sore nipples should be treated for thrush. Symptoms include burning nipple pain and shooting pain in the breast with or without nipple pain. This can occur without any signs of thrush in the baby’s mouth or diaper area.
Additionally, the La Leche League (LLLI) reports that nursing mothers may be at increased risk of developing thrush if their nipples are cracked or damaged, or if they are taking oral contraceptives or steroids (such as for asthma).
Many parents receive conflicting information about whether or not to treat thrush. According to Dr. Galland, the decision should depend on your child’s symptoms. If your baby is not eating due to the pain, treatment should begin immediately. If there are only white patches in the child’s mouth and no other symptoms, the baby’s immune system may take care of the thrush on its own.
“Theoretically, thrush doesn’t need to be treated unless it’s bothering Mom or Baby,” says Dr. Tobin. “However, on a practical note, I find it generally spreads and then begins to become bothersome until it’s finally treated.” She reminds parents to be patient. “Thrush is hardy and it can take time to get rid of it.”