Thrush is a yeast infection, which is bred in moist, dark environments. It is important to give a good history to an obstetrician, pediatrician, or lactation consultant when attempting to diagnose thrush, as there are some factors that are associated with the onset -- nipple damage, antibiotic use, and vaginal yeast infections during pregnancy or delivery are the most common. It can cause severe nipple pain, generally described as a burning, pins-and-needles type of discomfort. The nipple becomes very red or pink, often it seems shiny. It does not subside after the baby comes off the breast and can become gradually worse over time, until treated. Thrush can also present deep in the breast, where a mother may feel the same symptoms listed above, but with much more intensity and pain. Often, the baby will display symptoms as well--white patches in the mouth or on the tongue, fussiness, extensive diaper rash. The baby should be treated simultaneously with Nystatin oral suspension, even if showing no symptoms at all. Treatment consists of the following:
- Medication. If the mother has a nipple thrush, the doctor will most probably prescribe Nystatin cream. If she has a deep breast thrush, or the Nystatin has failed to do its job, it is possible that Fluconazole (Diflucan) will be prescribed (Mother must have a course of 14 to 21 days, not 1 to 3 days, which is appropriate for a vaginal yeast infection).
- Wash nipples with soap and water daily and always wash hands with warm soapy water.
- After feedings, the mother should rinse her nipples with water and then air dry. She should wear a clean bra every day.
- Change nursing pads at every feeding.
- Boil anything that comes into contact with the baby's mouth and with breast milk for 20 minutes each day.
- Use plain water to clean the baby when changing a diaper.
- If nipples are so painful and the mother can't have them touch her clothing, she should wear breast shells to alleviate discomfort.
- Add acidophilus to the mother's diet and avoid sugar and bread products.
- Gentian violet is an excellent natural remedy. It can be found in health stores. The yeast protocol for gentian violet is application once a day for 4 to 7 days. However, if the pain is gone, the mother should stop using it on day 4. If pain continues, she may use it until the seventh day, but it should not be used for longer than that. It is important to note here that gential violet has a deep purple hue and it will stain everything it comes into contact with -- skin, clothing, etc. Mothers are clothed and can hide that aspect of it, but babies will have purple mouths for a while.
Yeast infections can take a while to resolve. The mother must be careful to follow the protocol and to not become frustrated.
