breastfeeding and yeast infection

Some nursing moms will experience a little understood but not uncommon breastfeeding challenge: thrush. Thrush, simply put, is a yeast infection of the breast. Thrush affects the nipples initially, and it not treated quickly it can even go into the milk producing glands deep inside the breast. What's more, baby's mouth can become infected (and sometimes baby is the source of the initial infection) and baby and mom can even pass the yeast infection back and forth.

What are the symptoms of breast yeast infection?

Thrush is often quite painful, especially if it has gone undiagnosed for awhile.  Thrush can cause feeding difficulties because of the discomfort in the nursing infant's mouth. Some babies may fight or refuse the breast so prompt treatment is important for a successful nursing experience.

In many cases, thrush has no visible signs, however the mother may notice some of the following symptoms: pain when baby latches on that doesn't subside after a few seconds, white patches inside baby's mouth that don't wipe away (not to be confused with milk in the baby's mouth), a shiny red appearance to the nipple, itching or pain in the nipple, and sometimes mom will have a vaginal yeast infection and baby a bright red diaper rash.

What causes thrush/breast yeast?

The causes are many but most typically one of the following: If mom or baby has had recent antibiotic treatment, yeast is to be suspected. This is because antibiotics upset the balance of "good" bacteria in the gut, allowing yeast to overgrow. If mom had a Cesarean birth, she was given antibiotics in her IV, so yeast infection is common among these moms. Another cause is a poor diet (especially ones high in sugar) that weakens the immune system. Adding to the problem are hormonal factors. Since yeast is more common among pregnant women, often new moms are still carrying an active yeast infection when they give birth, so baby picks it up in the birth canal. Yeast infections are also more common in hot humid weather and in cartain parts of the country. Yeast loves warm sweaty places!

What can prevent yeast infection and thrush?

Obviously avoiding antibiotics unless absolutely necessary would be important. If antibiotics are needed however, it's a good idea for mom to eat lots of plain yogurt or kefir that has live active cultures. Supplementing with probiotics is also a good idea once the round of antibiotics is finished. Some more things that will help: change nursing pads after each feeding (and be sure to use cloth, not plastic/disposable pads), going braless occasionally allowing the nipples to breathe, wiping baby's mouth out with a soft clean handkerchief after nursing, and avoidance of refined sugars.

What do I do if my baby or I have yeast infection?

If a yeast infection is suspected, strict hygiene is necessary to keep it from spreading back and forth from mom to baby. Proper washing of hands with soap and water after all diaper changes and using the bathroom, not sharing bath towels, sanitizing pacifiers (or throwing them away, better yet) and bottle nipples, teething rings and all of baby's items that come in contact with their mouth in boiling water, or soaking them with vinegar can help as well. For persistent cases, sometimes it's helpful to treat the Daddy (or whoever has sexual contact with Mom, since it can be transmitted this way also, and men are rarely symptomatic).

There are some natural remedies for thrush also. For instance, you can apply a weak mixture of vinegar and water to the breast a couple of times a day. This creates an inhospitable environment for yeast to grow. If this causes burning, a mixture of baking soda and water can also be helpful.  Some moms have had good results with a little olive oil applied to the breast. 

In extreme cases, topical crèmes available by prescription, as well as oral antifungal drugs, can be used to treat the condition. Another common remedy is Gentian Violet, available in some pharmacies. It's very messy to use as it dyes everything it touches with a dark purple stain. There are some concerns that, even though it is natural, it may be carcinogenic. Some Doctors feel it's ok for very short term use, and it does seem to be effective. Ask your baby's Pediatrician or your OB/GYN for recommendations for other medications, for example Nystatin and Diflucan (the little pill some women are familiar with that is prescribed for vaginal yeast infections). Both of these medications are safe to use during breastfeeding and Nystatin is also be administrated to babies.

Yeast is a challenge to overcome, especially if it has a strong foothold in the gut. Yeast loves sugar, so it's a good idea to avoid sugar and white flour during treatment, as well as citrus fruits, sweets and junk food. Alcoholic beverages should also be avoided. Eating a whole foods diet with lots of vegetables and protein and including kefir or yogurt with active cultures will help the body kick the infection.

Natural Treatments For Breast Yeast And Infant Thrush

Baking soda
Baking soda can be an effective treatment for thrush. It changes the ph of the skin, inhibiting fungal growth. You can make a paste of baking soda and water and apply it to Mom's nipples. Rinse off before feeding the baby. Baby can also take baths with a little baking soda sprinkled in the water, which will soothe any yeasty diaper rash (it looks bright red and hurts).

Vinegar
Vinegar also kills yeast by changing the alkaline/acid balance of the skin, in the opposite way that baking soda does (obviously you would choose one or the other, not both treatments!). It can be irritating to the skin however, so care is needed. One tablespoon added to a cup of water and applied to Mom's nipples several times a day with a cotton pad can help.

Olive Oil and Coconut Oil
Olive and coconut oil are highly nutritious for lactating women and should be used daily in the diet. Both have antifungal properties and coconut oil in particular is excellent for immune system health. Coconut oil is delicious for baking, added to smoothies, used to cook eggs, etc. Olive oil is delicious in soups, casseroles, used to cook meats, etc. Olive oil and coconut oil can also be taken straight from the spoon. Some moms have had success applying a bit of oil to their nipples. both for pain and to help heal the infection. I wouldn't recommend leaving it on if the baby is a newborn, but it's fine for older babies who are eating solid foods. Don't shy away from healthy fats if you're in your reproductive years ladies. These two fats don't make you fat. Nursing Mothers all over the world since the beginning of time have thrived on high fat diets. Low fat is not healthy for the lactating or pregnant woman. And eating cheap oils means the fat in your breastmilk is of lower quality.

Strict Hygiene
Fungus is very hardy. Good hygiene is important if you want to prevent reoccurence. Wash your nursing bras and pads, panties and cloth diapers in hot water and do a double rinse. Add vinegar to the first rinse to help kill yeast and prevent irritation from detergents. Wash your hands well with hot soapy water after using the toilet or changing diapers. If you're using any bottles or pacifiers, boil them before use. Throw away nipples and pacifiers after treating the thrush and buy new ones. Or better yet don't use them if at all possible. Be sure to sanitize your breast pump parts too if you use one. Avoid plastic backed nursing pads. They create moisture and heat which yeast loves. Use cloth nursing pads instead. Go braless when you can to let the breasts air out. And don't use any type of soap on the breasts, ever.It's a good idea for Mom and baby to use their own towels and washcloths for awhile. Launder them separately, using the vinegar rinse mentioned above. If it's hot and sunny out, hang them in the sun to help kill yeast. Wipe baby's mouth with a clean wet washcloth or cloth napkin after feeding.

Herbal/Supplements
Garlic and Pau d'Arco have antifungal and immune building properties. Native Remedies is a good source of these and other anti candida supplements. Caprylic acid and oregano oil are also antifungal, and they're found in Yeast Assassin.

Nutrition
Another thing that will help is supplementing with probiotics. Eat plenty of plain yogurt, kefir and cultured veggies like homemade sauerkraut. These kinds of foods contain lots of beneficial bacteria that help keep the yeast in check in the gut. It's also very important to eliminate sugar while treating yeast infections. This will be hard because you'll crave it something terrible! But stay strong and remove sugar, white flour, all junk food and simple carbs (white rice and even fruit) for awhile. Eat plenty of meat and protein, and tons of vegetables while you're clearing the infection.

There are some prescription medications that you can get for yeast troubles from your baby's Pediatrician or your OB/GYN. One is Nystatin. It's commonly prescribed as a liquid suspension. It's sticky and full of sugar. I hated using that stuff. It didn't work, and it only made me and the baby and my clothes stick together like glue. And the sugar content - hello!

Another old fashioned remedy is Gentian Violet, sold in some pharmacies. I tried this one too and it's messy to work with because it stains everything bright purple. I couldn't take my baby out for a week because he looked like Papa Smurf. And I had to wear an old purple T shirt so as not to ruin my entire wardrobe. But it is pretty effective. There are some concerns about Gentian Violet being carcinogenic with long term exposure, but it typically only has to be used for a day or two to work so most people who care about babies and mothers say it's ok for this short term use. It's also very inexpensive and available without a Doctor's prescription or even a visit to the office.

Diflucan was the ticket for me. Along with the nutrition and other self help measures listed above, we finally kicked it for good. The thing with Diflucan is that a lot of Doctors who are ignorant of how breastfeeding works will tell you that it's not safe for nursing moms. That's pretty ridiculous because Diflucan is prescribed for premature infants! Medications and Mother's Milk is considered the authoritative source on the safety of various drugs for breastfeeding women and Diflucan gets the ok. As for me, we had tried everything else first and the meds helped me get relief, fast so it was worth it.

More Resources for Breast Yeast Infection:

Motherlove Diaper Rash & Thrush Relief Salve