Thrush is another name for a yeast infection. When breastfeeding, if either you or your Baby develops a yeast infection, you will both be affected and should both be treated. It is sometimes difficult to determine who has started the infection.
What causes thrush? A baby may have been exposed to yeast in the course of being delivered. A mom who has been prone to vaginal yeast infections may be more prone to thrush. If you received any antibiotics during labor (if the yeast infection occurs early in the postpartum period) or if you are taking antibiotics for another reason, this may be a factor. Antibiotics work to kill of harmful bacteria and in the process can kill off "good bacteria" that helps to keep yeast in check in your body. Yeast thrives on moisture and sugar—both of which are in abundance when you are breastfeeding!
Mom's symptoms of thrush include:
- Itching, burning or "pins and needles" feeling of the nipples and sometimes into the breast
- Reddening, shiny or appearance of your nipples
- Painful latch
- Pain during and after feeds
- Fussiness with feeds (if her mouth is sore, drinking may be uncomfortable)
- Bright red, raised patchy diaper rash that is difficult to clear up
- White spots in her mouth (not all babies will have this symptom)
General thrush guidelines for mom:
- Start with a visit to a lactation consultant and/ or be diagnosed by your doctor.
- Begin treatment of both you and Baby right away.
- Insist that all family members who are caring for the baby practice scrupulous hand washing techniques.
- Wash all bottles, nipples, or pacifiers that the baby is using in hot water after each use.
- Sterilize breast pump parts if you are using one.
- Change breast pads frequently to cut down on moisture.
- Wash bras and clothing in hot water.
- Try taking in lactobacillus acidophilus (either in yogurt or as a dietary supplement) to boost/support your intestinal flora.
- Talk to your pediatrician about acidophilus supplements for your baby.
- Allow your nipples to air dry when possible after showers and feedings.
- Reduce your dietary sugar intake. (Remember: yeast loves sugar!)
- Rest! Anything you can do to help boost your body's overall health will help!
Thrush treatments include:
- Nystatin cream (an anti-fungal agent) to be applied to your nipples after feeding and areola for about 10 days.
- Nystatin drops to be swabbed inside your baby's cheeks and mouth after feeding for about 10 days.
- Anti-fungal diaper cream to help clear up diaper rash.
- If the cream is not working, your doctor may recommend trying a course of oral medication called Diflucan for 14 days (sometimes longer).
- Gentian violet—a dye that when comes into contact with yeast, kills it —may be recommended. This is a messy proposition but can work effectively if nothing else is working. It involves using a cotton swab to paint the inside of the baby's cheeks and mouth. Check with your health care provider for tips on safe and effective use.
- A vinegar rinse—one tablespoon of white vinegar in one cup of water. Rinse nipples and allow to air dry. You can also use this on the baby's diaper rash.
Take all medication and complete all recommended course of treatment—just because you are feeling the symptoms improve; yeast can be stubborn and can flare up again—be diligent!
Once you begin to treat the yeast, you should notice symptoms improving over a few days. If you are not noticing an improvement, make sure to follow up with your health care provider.