Difficult latch-on with thrush

My 5 week-old daughter has been receiving treatment for thrush, for almost two days. She is having difficulty latching on. She did not have a problem before. She had gained 1 1/2 pounds since birth. She seems to be chewing on the nipple instead of sucking. I am concerned about the baby not getting enough milk, as well as my milk supply. I would appreciate any suggestions.

Thank You

Silvia

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ABOUT THE EXPERT

Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Dear Silvia,

When a baby has a thrush infection, their mouth can be very sore or itchy. A baby often does have difficulty breastfeeding when she has a bothersome case of thrush. Use of a medication, such as Nystatin, does not always immediately take away the symptoms. In fact, for the first 3 days or so, the person being treated may not feel much relief.

To properly apply Nystatin, pour the amount needed into a small (bathroom-sized paper) cup. When applying, use a clean cotton swab each time you dip into the medication. Swab all areas of your baby's mouth, including gums, roof of mouth and tongue. Repeatedly dipping into the bottle that holds the medication can contaminate the solution.

It is important that you are being treated (for nipple thrush) at the same time as your baby, and for a period of at least 2 weeks. Thrush can be readily passed back and forth between family members, so treating everyone in close contact is important when working to eliminate it. Wash your hands frequently with hot, soapy water and use paper towels for hand drying.

You must have a good milk supply since your baby has gained 1.5 pounds in the 5 weeks since her birth. I can understand your concern about her not getting enough milk now that she doesn't stay properly attached during a feed.

Most likely these difficulties will only be temporary. In the meantime:

  • Pay particular attention to positioning and attachment when nursing your baby. If she begins to chew on your nipple, or even slips down onto your nipple during the feed, it is important to gently break the suction, by inserting a clean finger in between her gums. Work with her to open wide and get a good mouthful of your breast. Pull her in close, so her nose and chin are gently touching your breast. Instead of using a finger to press down on your breast tissue to allow "breathing space", pull her bottom in closer to your body.
  • If you feel that your breasts are still full following a feed, or if they feel at all uncomfortable in between feeds, it would be wise to allow your baby to breastfeed again, or to express some milk.
  • Observe your baby's output. She is at the age when breastfed babies may decrease their frequency of stooling, but will make up for it in amount. At around 5 to 6 weeks of age, a breastfed baby should be wetting 5 to 6 diapers each day and should be having regular, substantial bowel movements.
  • If you see that your daughter's output begins falling short of the levels listed above, it would be wise to have her Health Care Provider check her weight. Normal weight gain until 6 months of age is between 4 and 8 ounces per week.

Best wishes for a quick return to comfortable nursings for both you and baby!

Warmly,
Debbi

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