Breastfeeding mums, you probably know about nipple thrush. It's a common yeast infection that can affect your nipples and/or your baby's mouth. It's not just painful, it can also make breastfeeding difficult—and sometimes impossible.
Breastfeeding has a host of benefits for both baby and mummy. But like anything baby-related, it comes with its "highs" and "lows". There's plenty that has been written on the high points of breastfeeding so let's focus on a relatively common and painful issue breastfeeding mums may face -- nipple thrush.
What Is Nipple Thrush
If you feel shooting pains in your breast while breastfeeding or your nipples are itchy, shiny and red, you might very well have nipple thrush.
Nipple thrush is caused by a fungus called candida albicus. According to Dr Sears, this fungus thrives in warm, dark, moist areas of the body such as the mucus membranes of the mouth and vagina, baby's diaper area, bra pads, and continuously wet nipples.
When this fungus propagates and starts thriving on your nipples, the result is, you guessed it, nipple thrush (also called nipple candida)
What Are the Nipple Thrush Symptoms
Check your breasts for the following symptoms of nipple thrush:
- Itchy or burning nipples that appear changed in colour; shiny, puffy, flaky, and/or have a rash with tiny blisters
- Shooting pain in the breast during or after nursing radiates from the nipple into the breast, back, or arm.
- Intense nipple or breast pain that doesn't improve even with better latch-on and positioning
- Deep breast pain can be described as ‘liquid fire’, ‘hot needles’, ‘razor blades’, 'a piece of glass stuck in my nipple’, etc.
- Cracked or sensitive nipples/areolas to light touch (clothes or hot water spray in a shower)
You can also suspect candida as the cause of your sore nipples if:
- Your baby has oral thrush and/or a yeast-related nappy rash
- Your nipples suddenly become sore after a period of pain-free breastfeeding
- You are currently on antibiotics or have just finished a course
Nipple Thrush While Breastfeeding
If you are breastfeeding and your little one has oral thrush, according to the National Health Service, UK (NHS), there’s a chance the same fungus that caused it can also give you nipple thrush.
Breastfeeding creates the ideal environment for candida albicus as it thrives in warm, moist, dark and sugary places such as your little one's mouth during nursing. You also may be at higher risk for developing breast and nipple thrush if:
1. You or your baby had a recent course of antibiotics: Medical experts claim that antibiotics can reduce the number of bacteria that usually control candida fungus.
2. You had vaginal thrush while pregnant: During pregnancy, the higher levels of estrogen and progesterone encourage yeast colonisation as the pH levels of the vagina change. Health professionals say that your little one can develop oral thrush if this is not treated and you've had a natural birth. This infection can then be passed on to you during breastfeeding.
3. Your nipples are cracked or damaged: If your baby has oral thrush, the infection can easily transfer to you via cracked nipples.
4. You are taking oral contraceptives or steroids: According to Baumslag and Michels (1992), mums who take oral contraceptives containing estrogen are also more likely to experience yeast infections. Other medical professionals, such as Ruth Lawrence in Breastfeeding: A Guide for the Medical Profession, report a connection between long-term steroid use (such as those used for asthma or severe allergies) and yeast infections.
How to Treat Nipple Thrush
According to the NHS, if you have thrush in your nipples, your doctor will normally advise you to continue breastfeeding while using an antifungal cream to treat the infection.
La Leche League International (LLLI) lactation experts say that treatment may be given four times a day or after each nursing session. It is also advisable to continue the treatment for two weeks after your symptoms have disappeared. Remember that the symptoms may worsen for a few days after treatment begins, after which you should start feeling better.
Prevention Tips for Breast and Nipple Thrush
Breast and nipple thrush, once contracted, can be quite tough to get rid of and may be very uncomfortable and painful. Because of this, it is best to arm yourself with information on how to avoid it in the first place.
Here are some great tips from LLLI and Dr. Sears on preventing nipple thrush:
- Wash hands often (before and after nursing, after using the bathroom, and before or after changing the baby’s diaper). Use hot, soapy water and paper towels.
- Numb the nipple with ice wrapped in a washcloth before beginning to nurse.
- Offer your baby short, frequent feeds, starting on the side that hurts the least. Yes, nursing your baby with this condition can be painful. But you must empty your breasts regularly to prevent a condition like mastitis from setting in. If it becomes too painful to nurse, you may want to pump your milk temporarily and feed it to your baby by cup or bottle until the pain lessens.
- Try drinking green tea 3 or 4 times a day. It may help cleanse your system of excess yeast.
- Eating yoghurt that contains live active cultures or taking oral acidophilus can encourage the growth of good bacteria in your gut, preventing yeast growth.
- Decrease consumption of foods containing high amounts of sugar and/or yeast (such as beer, wine, sodas, bread, desserts, etc.).
- You may find that reducing yeast and sugar in your diet during a thrush outbreak helps.
- If your baby uses a pacifier or bottle nipple, you should boil it for 20 minutes daily and replace it weekly.
- Avoid plastic-lined breast pads that could trap leaked milk and moisture. Remember to change your breast pads after each feed.
- If you are pumping, thoroughly sterilise all breast pump parts that come in contact with milk.
- Do not freeze breastmilk you pump during an outbreak of thrush. Freezing breastmilk does not kill the yeast in it.
12. Any toys that go into your baby's mouth should be washed well with hot, soapy water.
13. Wash all items of clothing that come into contact with your nipples in hot water and dry well in the sun. Yeast organisms hate sunlight, so expose your breasts and nipples to sunlight for a few minutes several times a day.
14. Rinsing your nipples with a solution of vinegar and water (one tablespoon vinegar to one cup of water) after every feed can help. Use a fresh cotton ball for each application and make a new solution daily. Remember to let your nipples air dry after each application
If you do suspect you have nipple thrush, do consult your doctor without delay. He can assess your situation and decide on the best course of treatment. Be vigilant about taking the prescribed medication for as long as the doctor asks you to completely and effectively eliminate the thrush infection.
When in doubt, please refer to a lactation consultant who can offer you more personalised advice regarding your and your baby's situation.
theAsianparent also has a Singapore Breastfeeding Mums Support Group that you can join for mum-to-mum advice.
Updates by Pheona Ilagan
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Mayo Clinic, LLLI, NHS, NLM, Dr Sears
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