What is Thrush?
Ouch! Your nipples are shiny, pink, flaky, and they itch! Sometimes it feels like you’re shooting bolts of lightning from deep inside your breast during, or after, nursing. The pain doesn’t go away even with different positions, latch correction, and lotions. Your nipples are so tender that your toes curl with the thought of wearing your bra!
Or, suddenly your infant becomes reluctant to breastfeed, latching and popping off, or outright refuses the breast after a sample suck. It looks like there’s cottage cheese inside your baby’s mouth, different from the normal milky coating after a feeding. This stuff is stubborn to wipe off and your baby’s cheeks bleed when you finally get it off. You’ve also noticed a bright red diaper rash, with patches that have a sharply defined border, and no amount of diaper cream seems to heal the irritation. Your baby could be gassy, fussy and seemingly unhappy.
What is happening?
Thrush! Candida Albicans, a fungal organism, has apparently caused what is known as yeast infection, either orally in your baby, or deep within your nipple of one, or both, breasts. Thrush thrives in warm, moist places. While your body’s natural flora usually keeps yeast growth in check, sometimes cracked nipples, antibiotics during your labour or for baby after birth, and certain contraceptives or steroids can cause thrush. And it’s definitely uncomfortable!
You’ll need to see your healthcare provider as soon as possible if you suspect there's thrush. Yes, even if you or your baby are asymptomatic, it is imperative that both of you are treated simultaneously. Since thrush recurs very easily, it is important to follow the full course of treatment, even if symptoms subside. This may include treating baby’s mouth and diaper area, your breasts and vagina, as well as other family members. There are many strains of yeast that are resistant to common medications. Various treatment regimens exist for both oral and nipple thrush. Antifungal topical agents, such as Nystatin, Clotrimazole, Miconazole Nitrate, Ketoconazole, Ciclopirox or Naftifine Hydrochloride are often prescribed. While Nystatin is often the first treatment suggestion, other topicals are usually more effective. Your physician may also suggest adding lactobacilli, acidophilus, garlic, zinc, or B vitamins to your diet, and recommend reducing your dairy and sugar intake.
Further considerations during a Candida treatment should focus on good hand washing practices. Anything that comes in contact with your breasts, such as bras, nipple shields, or breast pump parts should be boiled for 20 minutes once a day. If your baby uses a pacifier, bottles, or teething toys, these should be boiled daily as well and replaced every week. All toys should be cleaned thoroughly with hot soapy water, and all of your family’s clothing, bedsheets, and towels should be laundered in hot water. It is also suggested that pumped milk can be fed to your baby while it’s fresh, but breastmilk should not be frozen for future use, since freezing will not kill Candida.
Remember, thrush is a common condition and responds well to treatment. Thrush is not a sign that you are not properly caring for your baby! Candida Albicans is always present and a normal organism found in healthy people.
We encourage you to learn more about our "What in the World" series. Please see our A to Z index for a whole host of pregnancy, postpartum, and parenting information and terminology.
Loree Siermachesky works as a multi-certified labour and postpartum doula, certified Lamaze childbirth educator, certified breastfeeding counselor, certified placenta encapsulation specialist and a certified car seat technician in Medicine Hat and Lethbridge. She has had the honour of attending over 1400 births in the last 20 years. She is well-known and greatly respected by the medical providers in Medicine Hat, Lethbridge, Brooks, Taber, and Calgary. She cares deeply for this profession and even more for her clientele, honoring them in whatever method of birth they choose, or helping them transition to new parenthood as they wish.