When you hear the phrase “yeast infection,” you likely don’t associate it with breastfeeding. Yet as many moms know, breastfeeding and yeast can combine to cause an unpleasant, painful infection in both Mom and Baby called thrush.
What is Thrush?
“Thrush is a yeast infection in the mouth,” says Dr. Deborah Lehman, a pediatric disease specialist at Cedars-Sinai Medical Center in Los Angeles. Yeast fungus, also known as Candida albicans, thrives in moist, dark areas—so an infant’s mouth is an ideal place for thrush to take up residence.
Babies can get thrush in several ways. Exposure to antibiotics (either by the child or a breastfeeding mother) can cause thrush since the antibiotics kill the friendly flora, or bacteria, found naturally in the human body, allowing the yeast to thrive. Some babies become infected when they make the trip down the birth canal, while others contract thrush from pacifiers and bottle nipples. Babies are susceptible to thrush because “their immune systems are weak and are not fully matured,” explains Dr. Leo Galland, co-author of Superimmunity for Kids).
“Infants can’t tell you what they’re feeling, so [go by] what you see,” recommends Dr. Galland. White patches on the gums and tongue that cannot be scraped off are a telltale sign of thrush (if it’s milk, it can be scraped or wiped off). Other symptoms include fussiness, irritability, and discomfort when eating.
According to Dr. Cathryn Tobin, pediatrician and author of The Parent’s Problem Solver, “A mother who has been breastfeeding without pain and develops sore nipples should be treated for thrush. Symptoms include burning nipple pain and shooting pain in the breast with or without nipple pain. This can occur without any signs of thrush in the baby’s mouth or diaper area.
Additionally, the La Leche League (LLLI) reports that nursing mothers may be at increased risk of developing thrush if their nipples are cracked or damaged, or if they are taking oral contraceptives or steroids (such as for asthma).
Many parents receive conflicting information about whether or not to treat thrush. According to Dr. Galland, the decision should depend on your child’s symptoms. If your baby is not eating due to the pain, treatment should begin immediately. If there are only white patches in the child’s mouth and no other symptoms, the baby’s immune system may take care of the thrush on its own.
“Theoretically, thrush doesn’t need to be treated unless it’s bothering Mom or Baby,” says Dr. Tobin. “However, on a practical note, I find it generally spreads and then begins to become bothersome until it’s finally treated.” She reminds parents to be patient. “Thrush is hardy and it can take time to get rid of it.”
There are many ways to eliminate thrush. Nystatin is a common prescription for thrush. A cream containing Nystatin is generally applied topically to the nipples, and baby may be prescribed a liquid form of Nystatin that is swabbed on the white patches in her mouth. Dr. Lehman says it’s important to use the medication the baby is prescribed on everything baby puts in her mouth, such as pacifiers and bottle nipples.
Gentian Violet is an antifungal agent that can also be applied to thrush. Dr. Tobin recommends applying a one-percent solution once a day for three days using a cotton swab (allow your baby to suck on the tip of the cotton swab). It should also be applied to mom’s breasts, bottle nipples, and pacifiers. What about the colorful reputation of this purple remedy? “Gentian Violet is messy but highly effective,” says Dr. Tobin. “While it stains clothing, it does not stain skin … the color disappears in a few days.”
According to Dr. Shari Lieberman, author of The Real Vitamin and Mineral Book, an excellent way to treat thrush is to restore the friendly flora. The most important way to achieve this is to continue breastfeeding, because breast milk contains a friendly flora known as bifidobacteria.
Moms may also take acidophilus, garlic, and/or oil of oregano—all three help to kill yeast (these three also work well for non-breastfeeding moms who have thrush). Baby will inherently gain the benefits of this treatment via Mom’s breast milk.
Dr. Lieberman says other measures to help prevent and treat thrush include taking a quality prenatal vitamin; disinfecting (boiling) all pacifiers, toys, and bottle nipples; and avoiding alcohol and sugar.
Dr. Galland recommends a healthy diet, taking flaxseed oil supplements, and eating plenty of green, leafy vegetables. He also suggests talking to your doctor about taking extra vitamin supplements.
Pumping Milk for Baby
Mom can continue to pump breast milk, even while experiencing thrush, unless it’s just too painful to do so. According to Dr. Lieberman, “You’re basically pumping food and you should treat it the same way you treat food.” Sterilize and disinfect tools as instructed on the breast pump.
Mary Talbot came face to face with thrush after her son Connor was born. Connor developed thrush in his digestive tract after being prescribed antibiotics as a pneumonia precaution. “He’d suck once, then cry because he was hungry,” says Talbot. “We are now more hesitant to put him on any kind of antibiotics.” Talbot says The Nursing Mother’s Companion by Kathleen Huggins was very helpful in treating her son’s thrush. “The one thing we did find when he got really bad [was that] he could drink from a bottle easier [than nursing].” Talbot would pump, then bottlefeed Connor her breast milk. Because the thrush wasn’t causing Talbot much discomfort, it didn’t hurt her to breastfeed or pump.