Parentpedia

What Experts Say^*

Thrush is an overgrowth of candida albicans, a fungus that is always present in our bodies. Yeast may be encountered during birth, as your baby travels down the birth canal. Antibiotic exposure during labor can also set you or your baby up for a fungal infection.

"Candida thrives in the warm, moist areas of the infant's mouth and on the mother's nipples ... Mothers with vaginal candidiasis (yeast infection) and nipple trauma are predisposed to candidiasis of the breast," writes Jan Riordan, author of "Breastfeeding and Human Lactation."

Tips and Advice If You're Nursing With Thrush

You may experience pain and soreness after a period of nursing comfortably.
Thrush can also appear in the first few weeks of breastfeeding and be misdiagnosed. Mom's symptoms of thrush include:

• itchy or burning nipples that appear red or deep pink or shiny with tiny blisters
• deep shooting breast pain
• intense nipple pain that doesn't improve after correcting positioning and latch on

Your baby may seem uncomfortable, or be without visible symptoms.
Babies' symptoms of thrush include:

• white patches on the inside of the lips, cheeks, and tongue that can't easily be wiped off
• a whitish sheen to the inside of lips
• red, raised diaper rash, resembling a burn with distinct borders
• fussiness and/or gassiness

Work with a lactation consultant and your physician if you suspect thrush.
A doctor or board-certified lactation consultant (IBCLC) needs to examine your baby to diagnose thrush. Get hands-on help from an IBCLC, who will take a complete history, examine your nipples and your baby's mouth and diaper areas, and make recommendations. She will work along with your doctor to help you get the treatment you need.

You and your baby need to be treated simultaneously.
This is important, even if your baby doesn't have visible symptoms, so you don't pass thrush back and forth.

Talk with your doctor about the different over-the-counter and prescription medications. Continue treatment for two weeks after you and your little one are symptom free.

Thrush is considered a family disease. In cases where thrush is not responding to treatment, it is important to also treat your partner and use condoms, as sexual contact can spread the infection.

Symptoms may initially appear worse after treatment.
This is normal. If thrush has not been around long, you may feel better within a couple of days, but when it has been a more longstanding infection, it can take five days or longer to get relief.

Try shorter, more frequent feeds.
Though it may seem counterintuitive, you'll probably find this to be more comfortable. When it hurts to nurse, start on the least painful side. Move your little one over as your milk lets down.

Rinse your nipples with a vinegar and water solution following a feed.
Use one part vinegar mixed with four parts water. Apply using a cotton ball. Make a new batch of solution each day.

Keep your nipples free of moisture.
Remove nursing pads as soon as they become wet. After nursing, air dry your nipples. Go topless, bra-less, or leave the nursing flaps of your bra open when you can. If possible, expose your breasts to sunlight for 15 minutes a day.

Wash your hands frequently.
Use warm soapy water and wash your hands for 20 seconds before and after feeds, diaper changes, using the bathroom, and as needed throughout the day. If your baby sucks on her fingers it's also important to wash her hands. Use paper towels for drying.

Wash all clothing that comes in contact with your nipples each day.
Use hot water and bleach if possible. Dry in a hot dryer or in the sun. Use of a hot iron can also kill yeast.

Sterilize items that come in contact with your breasts, your milk, and your baby's mouth.
Once a day for 20 minutes, wash and boil bottle nipples, pacifiers, breast shells, teething toys, and breast pump parts that come in contact with your milk. Replace all items except breast pump parts once a week.

Take a look at your diet.
If you're struggling with thrush, it can be helpful to restrict sugars, artificial sweeteners, alcohol, and wheat and dairy products.

Consider using of an acidophilus supplement (40 million units a day), or eat a sugar-free yogurt each day to help re-establish helpful bacteria. Continue dietary changes at least two weeks after you no longer have symptoms.

Use a pain reliever/anti-inflammatory if needed.
Most medications of this type are compatible with breastfeeding. Check with your doctor.

Safety Note

• Do not freeze your milk when you have thrush. Freezing breast milk inactivates the yeast but does not kill it, so if you have saved milk in the freezer, feed it to your baby while you're both being treated.
• Other causes of sore nipples or deep breast pain include, but are not limited to:
  • positioning and attachment
  • plugged ducts or mastitis
  • skin conditions such as eczema, psoriasis or dermatitis
  • vasospasm/Raynaud's phenomenon