What can I do about thrush?

My baby has thrush, and now I have it too. I’m frustrated and not sure what to do.

Question:

I can understand your frustration. Breastfeeding has become painful for you, and you may fear that you and your baby are passing an infection back and forth. Keep in mind that many mothers and babies have experienced this problem without loosing their breastfeeding relationship.

The spores that cause fungal infections, such as thrush, are common environmental contaminants. When they cause symptoms, it usually means that certain conditions have helped them to get out of control.

Symptoms of a fungal infection are the dramatic increase in nipple pain while breastfeeding or pumping, or sudden pain when feedings had been pain-free. Some mothers describe a fungal infection as a burning sensation in their nipples and/or shooting pains into the breast. This pain is accompanied by a change in color of the nipples that is in the pink-to-red range. Sometimes the skin around the nipple (areola) appears shiny as well. An important part of getting rid of this infection is to understand how it began.

When mothers and/or babies are treated or exposed to antibiotics, good bacteria, which help keep fungal infections in check, are also destroyed in their bodies. Many doctors recommend taking a replacement for these bacteria, such as acidophilus, following antibiotic therapy. You may want to check with your healthcare provider about taking acidophilus to help your body fight off the fungal infection (even if you haven’t taken antibiotics).

Your nipples will be more susceptible to fungal infections if they’re irritated by incorrect latch-on during breastfeeding. If you had nipple discomfort or pain even before developing the fungal infection, you will need to correct your latch-on technique so your body can fight the infection. If this is the case you could benefit from speaking with an International Board Certified Lactation Consultant.

As you’ve unfortunately already discovered, infection-causing spores can be passed around. They also can survive on surfaces like pacifiers or toys that are sucked or chewed. Items which are in contact with your baby’s mouth and your breasts should be sterilized and/or boiled.

Drying your undergarments in a hot dryer will also kill fungal spores. Avoid sharing towels among family members or even using towels over different parts of your body after drying your breasts to prevent spreading the infection. Try to identify the source of the infection in the household: It could be a case of athlete’s foot, jock itch, a vaginal yeast infection or a toenail or fingernail infection. Be sure to treat these conditions aggressively.

Some persistent cases of fungal infection respond well to changes in maternal diet, including the elimination of refined sugar, decrease in carbohydrates and avoidance of yeast-containing products.

Antifungal prescription medication and medical care can help you cure the infection you have. Most doctors prescribe two medications. One is an oral suspension to treat the inside your of your baby’s mouth (Nystatin) and another is cream or ointment for your nipples (Nizorel or Lotrizone).

When administering the medicine to your baby, be careful not get saliva in the medicine bottle. If you use a dropper, measure the medication with one dropper and place the medicine in a small container. Use a different dropper to administer the medicine to your baby. Some doctors recommend wiping the inside of your baby’s mouth with a sterile gauze before administering the medication so it has more access to the surfaces of your baby’s tongue.

When applying medicine to your nipples, wash your hands with soap and water before and after. Depending on the medication prescribed, you may need to wipe it off your nipples prior to feeding.

If these medications are not effective, oral medication may be prescribed for you and your baby. Although the stronger medications, such as Diflucan, have a greater risk of side effects, these are rare and the medication is usually very effective. These oral medications are usually taken for several weeks when used to treat oral thrush or fungal infections on the nipples or inside the breast. This is different than the short-term, single dose, which is sometimes used to treat a vaginal yeast infection.

All forms of treatment take a while to begin to work. Your symptoms should be noticeably improved in three to five days from starting treatment. If you don’t notice improvement in that time period, consult with your doctor about moving on to stronger medication.

Although this rigorous approach may seem overwhelming, the rapid results and the ability to continue breastfeeding without pain can help you get through it. For some mothers the nipple pain is so intense that they need to temporarily discontinue breastfeeding. If you choose to do so it is important to drain your breasts regularly (at least as often as your baby’s feedings). A hospital-grade rental pump will be the most comfortable. Make sure you sterilize the collection kit between pumpings.

If necessary, seek the assistance of an International Board Certified Lactation Consultant to modify the plan to your needs and/or to assist you with the resumption of breastfeeding.

 

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