How to Treat Thrush While Breastfeeding

woman breastfeedingMany breastfeeding moms run into uncomfortable related ailments. One common challenge: Fungal infection of the nipples, or thrush, an overgrowth of yeast that can be triggered by antibiotics or the nipples being persistently wet. (Yeast tends to thrive where warmth, moisture, and sugar is present.)

One in four infants will develop oral thrush and pass it on to their mother before reaching 18 months. An infection is marked by itchy, pink, red, shiny, or burning nipples (may be cracked), deep, shooting breast pain during or after feedings, and even a vaginal yeast infection. Babies may have thick, white patches in the mouth and/or a red diaper rash. 

Because thrush is one of the most over diagnosed breastfeeding ailments, according to International Board Certified Lactation Consultant (IBCLC) Freda Rosenfeld, it's imperative to rule out bacteria, dry skin, or eczema, or other things that could cause sore nipples.


Once candida is diagnosed by a health care provider, both mom and baby require treatment.

How to get relief:

Antifungal creams: Treatment from your health care provider will often involve antifungal creams, such as the prescription antifungal cream nystatin, which you'll apply to your nipples to kill the infection. More than 40 percent of yeasts are resistant to nystatin, however, so alternatives may include over-the-counter creams, such as miconazole (Monistat-Derm) or clotrimazole (Lotrimin or Mycelex). Whichever you go with, women general get relief within 24 to 72 hours, but are generally advised to apply the cream after every nursing for a week to ten days. 

If topical treatments aren't working, your doctor may prescribe a 14- to 21-day course of the oral antifungal drug fluconazole (brand name Diflucan). It is recommended that breastfeeding continue during treatment, and the medication is safe for a nursing infant. But as with any drug, moms should discuss the benefits and risks with their provider. 

Relief for baby: Pediatricians generally prescribe nursing women diagnosed with thrush nystatin (also called Mycostatin Suspension) for their baby, as well. Treatment entails "painting" the cream onto the white patches that tend to appear in the child's mouth with the the enclosed applicator (or your finger) several times a day for ten days, preferably after nursing.

Continuing to breastfeed: Although it can be extremely painful, keeping the affected breast(s) empty will help prevent additional infection, such as mastitis or candida lodging deeper into the breast tissue. Experts recommend consulting with a lactation specialist to ensure proper technique. Proper latch and easing the baby off of the nipples will keep further discomfort at bay.

Probiotics: If you are taking or were recently on antibiotics, most doctors will recommend taking probiotics to strike the right balance of healthy gut flora, notes Rosenfeld. And even if you didn't take antibiotics, probiotics can help speed healing of thrush. Try yogurt with live lactobacillus acidophilis cultures or capsules with 40 billion units a day.

Staying light and dry: Air-drying nipples and change nursing pads after each feeding will help keep yeast at bay, as well taking a "sun bath" for several minutes several times a day, as yeast hates light.

Sterilization: Bottles, pacifiers, and breast pumps can often contribute to the problem by harboring yeast. It may help to sterilize in an electric steam sterilizer or boiling water for 20 minutes after each use, to avoid reinfection. It's also recommended that women wash their hands frequently, particularly after feedings.

Ultimately, by employing a multifaceted approach, nursing moms and their babies often experience speedy recovery from this uncomfortable, but all too common condition.

Have you ever had thrush? How did you address it?


Image via motheringtouch/Flickr

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