What is Thrush?

We all carry Candida Albicans (thrush) in our bodies.  It's a normal part of our digestive system, and bacteria usually keep it in check.  But now and then it gets a chance to grow and spread, which can lead to an infection.

Yeast grows well in warm, moist areas and can be traded back and forth between a mother and her baby.  Both mother and baby should be treated together in order to clear up the infection.  It is important to do this even if one of you does not have symptoms.

If you treat one of you and not the other, you may clear up the infection in one place only to have it reoccur a week or two later in another.

You may be at higher risk for developing thrush if you or your baby has had a recent course of antibiotics, your nipples are cracked or damaged or you are taking oral contraceptives or steroids (such as for asthma)

Thrush can be very difficult to treat.  Nystatin is considered to be less effective than other treatment options.  There are other medication options, including gentian violet and the over-the-counter treatment miconazole.  Decozol is a prescription only medication, though it is also Miconazole in a gel form.  There is also an oral medication that can be given for resistant cases.

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Symptoms of Thrush

  • Your nipples are extremely sore, burning, itching or red

  • You experience shooting pains in your breasts during or just after feeding (especially during your milk ejection reflex).  Sometimes this may continue between feeds.

  • The usual remedies for sore nipples aren’t working.

  • Baby has oral thrush (white, cottage-cheese-like patches on the tongue and sides of the mouth) and/or a nappy rash.

  • Your nipples suddenly become sore after a period of pain-free breastfeeding.

  • You are taking, or have just finished taking, a course of antibiotics.

  • Sometimes a white tongue is diagnosed as “milk tongue”.  It can be hard to tell the difference between thrush and milk tongue.  Use your finger and try to wipe away the white patch. If it comes off easily, it’s probably milk.  Thrush is harder to scrape away, and can even bleed slightly when removed.

Treating Thrush

  • Apply an antifungal cream (Miconazole) sparingly after each feeding (6-8 times per day) for 24 hours.  Then apply 3-4 times daily for 7 days.  The cream is absorbed quickly, and does not have to be removed before baby nurses.  If you feel that some ointment remains on your nipple, you may want to gently press a damp warm washcloth on the nipple and areola before nursing (to avoid the nipple being slippery).

  • Take probiotics.  The most common variety of probiotic is Lactobacillus Acidophilus, consider a variety that contains more Bifidobacterial than Lactobacillus.  This encourages good bacteria to live in your gut and discourages the growth of yeast.

  • Thoroughly wash pump parts/nipple shields/bottles/teats in a sterilising solution or boil them in water for five minutes daily.

  • Breastfeeding with thrush can be painful, but it is necessary to keep the affected breast empty to prevent mastitis, or even a candida infection deeper into the breast tissue. Pay particular attention to proper latch-on and easing your baby off your nipples at the end of the feeding, since infected nipples can be more sensitive and prone to injury.

  • Rinsing your nipples with a white or apple cider vinegar and water solution (1 part vinegar to 10 parts water) after every feeding is helpful.  Use a fresh cotton ball for each application and mix a new solution every day.  Put some of the vinegar solution on a breast pad and wear the pads, changing regularly.

  • Wash toys in hot, soapy water.

  • Yeast organisms hate sunlight, so give your breasts a sunbath a few times a day.

  • Adding half a cup of white vinegar to the warm water wash can kill of the fungal spores.  Be careful with hand washing, especially after nappy changes.

  • Some mums find that cutting down on sugary foods and foods containing yeast helps.

  • After 24-48 hours, you should feel some improvement. Sometimes you can tell a difference after just one application. The milk you pump during a thrush outbreak can be fed to your baby. Freezing breastmilk deactivates yeast, but does not kill it. There is still debate as to whether or not frozen breastmilk pumped during an outbreak of yeast will decontaminate the baby with thrush.