Thrush Infection When Breastfeeding

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How to know if you or your baby has thrush. Get remedies and treatments for getting rid of a thrush infection in you and your baby, especially when breastfeeding.

Mom breastfeeding baby

If you are breastfeeding and it suddenly becomes very painful, there is a chance you have thrush.

Thrush is a fungal yeast infection.

I had thrush/yeast issues with both Kaitlyn and McKenna. Twice with McKenna. Thrush/Yeast infections are very difficult to get rid of when breastfeeding, and I know from experience they are very painful for the nursing mother.

It all started with Kaitlyn, my second child. Kaitlyn was born a perfect nurser. She had perfect form and latch and was very efficient.

There was never any pain involved with nursing her. It was such a dream to have a smooth experience!

When she was about a month old, nursing started to get a bit painful. At first,  I thought it was normal. It was very painful for me when Brayden was first nursing, so I figured it was just the normal “callousing” coming a bit late.

But it just continued to get worse.

And worse.

I started to bleed from my nipples. Oh it was painful!

I called my lactation consultant friend and she attributed it to poor latch. I accepted that.

By the time Kaitlyn was 6 or 7 weeks old, my logical brain kicked in. It didn’t make sense we would spend a month nursing pain-free, then suddenly get so bad. My LC friend thought it could be she was sucking harder now, but it just didn’t make sense to me.

Plus, it was only getting worse.

I literally curled my toes in pain every time Kaitlyn nursed. It felt like someone was stabbing me with a knife in the breast. It hurt so much worse than anything had with Brayden.

Finally, one day, I Googled ‘bleeding nipples’ and up came information on Thrush!

Yes! That was the problem!

I read about it on several sites and realized that is what I had.

I contacted my doctor and also contacted Kaitlyn’s doctor.

Went went in to get Kaitlyn examined. She had some thrush spots in her mouth behind her lips, not on her inner cheeks or tongue where I was checking.

I wish I could say that after a week of anti-fungal medication, we were both perfect. No. It wasn’t until she was 7 months old that we were finally yeast free.

Yep. 7 months old.

But we did get things so I was not in sharp, shooting pain at even the thought of nursing.

So what is thrush? And what do you do about it? Let’s dive in.

Thrush/Yeast Infection Symptoms

Thrush is yeast. It is an oral yeast infection caused by Candida albicans. Thrush isn’t serious other than it can interfere with feeding baby, even if you bottle feed.

Thrush Symptoms in Baby

In a baby, you will likely see white patches in the mouth somewhere. The biggest sign for me was that she had what appeared to be a diaper rash, but it would not go away. It had red, raised bumps all over her diaper area.

Here are some common thrush symptoms in a baby:

  • White or yellow patches in the mouth. It can be on the gums, tongue, cheeks, or roof of the mouth
  • Corners of the mouth are cracked
  • Diaper rash that won’t go away
  • Fussy baby

Note that newborns often get a white milk leftover on the tongue after feeding. If you worry that is thrush, try wiping it with a clean cloth or gauze. If it comes off, it is just milk. If it comes off but the tongue bleeds, it is likely thrush. If it doesn’t come off, it is likely thrush.

You can find images of thrush in babies here.

Thrush Symptoms in Mom

If you are breastfeeding, if one of you has thrush, the other likely does also. For me, it starts with bright red nipples. They are also very sensitive all of a sudden.

It then moves on to burning. It can burn in the nipple area and when it spreads enough, it burns in the milk duct area, so you feel it everywhere your ducts are. At this point, you will have shooting pains when you nurse your baby.

You will start to crack in your nipples. And not just a “I am a first time mom nursing a baby” crack, but a full on split down your nipple. And in my case, blood gushing forth (sorry, but true).

You might also find you have a red rash on your breast like your baby might have on the bottom.

Your breast and/or nipples might be itchy.

Let’s put them in a nice, scannable list:

  • Red nipples
  • Sore nipples
  • Itchy nipples and breast
  • Dry, flaky nipples
  • Burning in nipples and breast
  • Sharp shooting pain

Causes of Thrush Infection

Thrush is a yeast infection and comes from a very common yeast. Some babies pick it up in the birth canal as they are born.

Babies born before 37 weeks old or who have a low birth weight are at higher risk for developing an overgrowth of Candida albicans.

It is also very common if mom or baby are on antibiotics (this was our problem every time). The antibiotics kill the good bacteria that keeps the fungus in check.

This yeast thrives in warm, dark, moist areas, so it can develop in the diaper area or it can develop on your own breast if you do not change wet or damp nursing pads often enough.

You can also get it if you have diabetes, use birth control pills, or are exposed through someone in the home having an infection caused by the same yeast (vaginal yeast infection, athlete’s foot, diaper rash, or jock itch).

Thrush Infection Treatment

You can treat this! It isn’t easy to get rid of, but you can treat it.

You Both Need to Be Treated

You will need to of course see your doctor AND your baby’s doctor, even if one of you does not have symptoms.

First, you both MUST be treated at the same time.

This yeast will pass back and forth between the two of you, so if one is treated at a time, the other will develop it and then you will never get rid of it.

Some doctors will try to treat just one you, especially if only one is showing symptoms, but you both must be treated.

Be firm about this.

When Kaitlyn was a baby, her doctor told me we both had to be treated at the same time.

When McKenna was a baby and I had yeast, she had no visible symptoms. I called the office and a nurse on the phone told me she couldn’t be treated if she had no symptoms. I was finally able to get an appointment and the doctor prescribed treatment for her.

Medications

Your doctor(s) will decide what is the best course of treatment, but I do think it is wise to be aware of some options when you go.

There are several treatment options out there.

Nystatin is a common first choice in treating mom and baby. For baby, it will be drops and for mom, it will be a cream in most cases.

Some sources believe Nystatin to be rather ineffective against yeast. We personally haven’t had luck with Nystatin alone at our house.

Yeast problems often develop when the immune system is low. So if you or baby (or both in my case) were on antibiotics, then that is likely when the yeast problem developed.

Probiotics, like acidophilus, might work to help you fight the yeast, though some have found it to hurt the situation more than help.

Gentian Violet is a very popular remedy, but one I have never used. Some readers swear by grapefruit seed extract. If you decide to try this, be sure you get something well-made since baby will be ingesting it.

The only thing that has worked for me to finally rid myself of the yeast is Diflucan. And not the “wimpy” route of diflucan, but the ‘take-several-pills-day-one-then-one-to-two-pills-daily-for-ten-days’ route.

Diflucan is a pill you take by mouth. I used that and some Nystatin on the breasts.

With McKenna, I had to get a new OB (the old one had moved). She is one who doesn’t believe much in treating thrush. She thinks it will go away on its own eventually. Well, maybe so, but try telling my bleeding nipples to wait two months and it will go away. So I had to push for the Diflucan treatment, but I got it.

Also, be sure to ask for Newman’s Nipple Cream prescription if you have cracked nipples. It has to be compounded. I didn’t get that until my second round with McKenna, and let me tell you, it is fabulous. So fabulous. I can’t believe I went through two rounds of infection before this heaven-sent drug was given me.

This cream has antifungal, antibiotic, and a steriod. It treats yeast and bacteria. It is sometimes called Dr. Jack Newman’s All-Purpose Nipple Ointment (APNO).

Understand that these treatments typically take weeks to work.

Diet

Some readers commented that diet change helped them. Maybe adding more yogurt (with active cultures). Some cut dairy. Yeast likes sugars, so going low-carb and high-protein with vegetables can help.

It is always important to stay well hydrated when fighting infection.

Hygiene

There are some nipple care actions to take. One is to let the nipples dry off completely before dressing, even after nursing. You want to keep them as dry as possible.

This type of yeast is very persistent and can linger on surfaces. You need to keep things clean that come in contact with the yeast.

Wash your hands constantly. Be sure you wash after feeding baby since you probably touched your breasts in the process. Make sure you wash after diaper changes. Keep hands clean.

You might have to have a separate towel for yourself to prevent spreading it around the house.

You want to clean your breasts with water or a water/vinegar mixture after each feeding.

You can also do nipple soaks, either in saline solution or in vinegar/water mixture (1/1).

Also, keep your nursing pads dry and fresh. Be careful with the nicer disposable pads. They can hold so much liquid you might be changing them too infrequently (I know from experience).

Some people even give up on nursing pads all together while treating yeast.

You also need to clean your clothes and bras regularly to kill the yeast that will have gotten on them.

One of the harder things is cleaning everything baby comes in contact with. If your baby mouths a toy, pacifier, or bottle, it needs to be sterilized and cleaned regularly.

If you pump, you will need to thoroughly clean all pump parts, also.

Also, the sun can kill yeast, so if you can get some sun exposure on infected areas of the body, that can help.

How To Prevent and Avoid a Thrush Infection

This sound pretty awful, right? It is! So here is how you avoid it getting bad:

  1. Be aware of the signs. A big part of my problem with Kaitlyn is I didn’t realize what was going on and it got really bad before we started treatment.
  2. This often happens after a round of antibiotics. If you or your baby are or have been on them, keep a lookout for symptoms. With Brinley, I worked hard to make sure I didn’t get mastitis because that leads to antibiotics, which for me, leads to yeast problems.
  3. Let nipples air dry after showering and/or nursing.
  4. Clean with water daily (to avoid, not treat).
  5. Keep nursing pads dry and fresh. As I said above, watch those nice and absorbent pads. They hold more than you realize.
  6. Keep hands clean.
  7. Treat cracks in nipples. The APNO cream I talked about above can heal cracks and help prevent yeast from really getting a holding.

Conclusion

It is important to note that freezing does not kill yeast, so if you store pumped milk from the time you were infected, you will reintroduce it when you feed baby that milk down the road.

Thrush is very contagious, but you can still be successful with breastfeeding even if you both contract it.

Know what your options are, be an advocate for you and your baby, and be careful and persistent as you work to get rid of the infection.

You can read more about my experience with thrush with McKenna in the linked posts below.

If you have pain when breastfeeding and it doesn’t sound like thrush, read up on mastitis.

Related Posts

This post originally appeared on this blog January 2011

Thrush infection when breastfeeding

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