Hi y’all! If you’ve landed on this post, welcome. In this article we are going to discuss what thrush is, symptoms and current at-home treatments (2021) for thrush in the breastfeeding mother and baby.
What is thrush?
Thrush is an overgrowth of yeast. That gnarly beast that can plague us in the warm, dark, camp crevasses of our bodies. You may be familiar with yeast infections that can present in the vagina or other areas of the body. Common symptoms in adults are itching, discomfort and sometimes odor.
In a newborn, thrush presents as white patches in the mouth (not just on the tongue). It will be patchy on the inner cheeks, roof of mouth and sometimes the tongue as well. It can, also, be a rash that is hard to treat in the diaper region. Prolonged and slightly different than a typical “diaper rash”. Newborns and baby’s will have discomfort from the symptoms and sometimes feeding will be painful for them and they may fuss due to the yeast patches in their mouth. They may latch differently, make a clicking noise while nursing, lose their latch frequently during the feed and act as if they have an oral aversion while the patches are present. They may latch in odd ways to compensate for the areas that are painful and cause cracks or damage to mothers’ nipples during the healing period.
For women who have yeast on their nipples, they may experience burning/stinging, itching, and “shooting pains” in their breasts, they may have had no history of nipple pain and have a sudden onset or have a vaginal yeast infection present as well.
Risk factors for thrush are antibiotics (were you Group B strep positive during labor, have a c-section or receive antibiotics for other birth related reasons?), a diet high in sugar or carbs, anemia in mother, diabetes, frequent yeast infections for mom, cracks or damage to nipples, maternal use of oral contraceptives containing estrogen, long term frequent use of steroids in mother or baby, allowing baby to use a pacifier, allowing damp breastfeeding pads to stay on breast for too long or using plastic lined nipple pads that prevent airflow to nipple.
Luckily, thrush can be treated quickly if caught early and treating *both* mom and baby simultaneously. There are prescription medications that can help, but at-home treatments are great as a first line of defence for most simple cases of thrush.
AT HOME & OTC TREATING THRUSH (YEAST):
- High-grade probiotic for mom and baby. This is the one I typically recommend for my breastfeeding moms: Klaire Labs Target B2 Breastfeeding Probiotic
- After nursing, rinse your nipples in a solution of 1 cup water mixed with 1 tbsp of white vinegar or baking soda. Pat dry and apply antifungal cream.
- Many physicians treat nipple thrush with a prescriptive Nystatin cream. However, other OTC (over the counter) medications may be more effective. Mycolog ointment or vaginal yeast medication such as, Monistat 7, Lotrimin AF, or Micatin are all good options.
- Whichever medication you use, apply medication after each feeding and remove it before feeding again. Use a cotton ball soaked in olive oil to remove the medication.
- Garlic – garlic is a very powerful supplement that can be added either in capsule form 4-6 capsules daily during a yeast outbreak or cutting raw garlic into capsule sizes and swallowing whole a few times per day. This is a good garlic capsule: Nature’s Way Garlicin HC
- Boil all pacifiers, bottle nipples, and pump parts for 10 minutes each day, or use Medela Quick Clean Microwave Steam Bags.
- Switch to disposable nipple pads or vinegar wash reusable ones and bras often.
- Change bra daily
- Because freezing does not kill yeast, any milk frozen during the infection will need to be boiled before being given to the baby. It could also be used later when the baby’s immune system is stronger. Milk pumped during the infection, but not frozen, can be fed to the baby within 24 hours of pumping.
- Treatment must be continued for at least 14 days even if symptoms disappear earlier.
PHARMACEUTICAL TREATMENT OF THRUSH:
(PCP, OB, MIDWIFE or PEDIATRITIAN WOULD PRESCRIBE THIS)
The two prescription medications for thrush on the market are:
- Nystatin
- Diflucan
They are both compatible with breastfeeding and are applied topically to a mothers breast and infant’s mouth. It is very important that mom and baby are being treated *at the same time* even if the other isn’t showing symptoms.
Treating with yeast medications, especially those that are topical, usually cannot hurt and can only help if yeast is suspected. If symptoms do not respond to treatment within 4 days, the treatment should be reevaluated. Failure to improve with aggressive treatment requires a look at possible other causes. Sometimes a bacterial infection can be present either alone or with yeast.