Breastfeeding & Thrush

Breastfeeding has been going really well, but all of a sudden your nipples are in agony. It seems as though it’s come out of nowhere and to the best of your knowledge you haven’t been doing anything differently to cause it.

It could be thrush!

Thrush is a fungal infection caused by candida or yeast, that occurs in the mucus membranes and/or the skin. It can be a real pain, literally, for both the breastfeeding mum and baby as it cross-infects from mum’s nipple to baby’s mouth and vice versa. It can also affect other areas of the body including the nappy area and looks like a raging nappy rash. If you or baby are infected with thrush, you need to be treated together. Even if one of you is not showing symptoms.

Many women get thrush in pregnancy and this can make you more susceptible after baby is born. It happens because yeast thrives on sugar, and there are elevated blood sugars in the presence of oestrogen. For that reason, it’s a good idea to cut down on sugary and carb-rich foods if you have, or had, thrush. You should also take a probiotic to help rebalance your gut flora, as a precautionary measure. You are also more susceptible if you or baby have had antibiotics.

What thrush looks and feels like for the nursing mum

If mum has thrush in her nipple she will likely feel a burning, painful sensation while baby is feeding and after. That’s a good way to diagnose whether its a latch, positioning problem or thrush – thrush pain will continue after the feed like shooting pains, while incorrect latch pain won’t usually. Mum might feel pain on the nipple itself but also deep within the breast.

Other symptoms

• Burning nipples that appear pink or red, shiny, flaky, and/or have a rash with tiny blisters. Infected nipples can look normal. They may also be itchy and hot and clothes rubbing against them may feel awful. You may also have cracked nipples
• Mum might also feel her supply has decreased. The pain can inhibit let-down and also, baby may not nurse as efficiently. This, in turn, can lead to blocked ducts and mastitis. Not good and makes for a very miserable mama. (Once the thrush is gone, supply can be built up again so don’t worry!!).

What thrush looks and feels like for baby

If baby has thrush in the mouth they are usually fussy on and off the breast. Baby will likely be out of sorts as he/she is in pain and could go on nursing strike altogether. Baby may, but not always, have a white coating on the mouth or tongue – like white spots.

Bear in mind, it is possible for baby to have an imbalance of candida with no visible symptoms. It is, however, more likely if you have taken antibiotics in the recent past, as these will typically remove good bacteria which protects against thrush. Good quality probiotics should always follow antibiotics for both yourself and your baby.

Baby might also have an angry red rash in the nappy area.

What can I do about it?

Firstly if you are experiencing the above symptoms you should contact your healthcare provider and discuss treatment options.

Please be aware that there are many other causes of nipple pain and these need to be ruled out before medicating for thrush. These include:

• A poor latch
• Tongue tie
• A bacterial infection and more!

A lactation consultant should be your first port of call to rule out the other possibilities. If you do have thrush, your GP may prescribe a cream to apply to the nipple, an oral suspension for baby’s mouth or both. Make sure you seek treatment for you and baby as cross infection is likely.

Here are some other helpful things to do

• Sterilise anything that comes into contact with baby’s mouth regularly – at least daily (soothers, toys, breast pump parts etc.)
• Nurse often and for less time if you need to
• Take painkillers and you can try numbing the nipple with ice before a feed if it is very painful
• If you are too sore to nurse, keep pumping to empty the breast – do not store or freeze this milk though as refrigerating does not kill thrush
• If possible, rinse baby’s mouth out by drinking water or wipe it with a damp cloth after feeding – yeast can feed on any milk left on the mouth
• Rinse nipples after feeding – vinegar in water is good for this (1tsp to 1 cup of water)
• Drink as much fluids as you can but not anything containing sugar! Water or herbal teas are good including green tea which has antioxidant properties
• Eat natural live (sugar-free) yoghurt to help rebalance and kill off candida
• Decrease foods high in sugar and yeast in your diet
• Take a good high strain probiotic
• Avoid breast pads and air the nipples as much as possible
• Talk to your healthcare provider about the possibility of using gentian violet to treat thrush
• Wash your hands and nursing bras regularly with hot water

Keep consistently treating it even after symptoms disappear.

Make sure you’re surrounded with lots of love, hugs and support and don’t give up on yourself or nursing – thrush can be really miserable, but it will go eventually.

This article was originally written by Lisa and Emily for www.eumom.ie