"Pain is no evil unless it conquers us." ...George Eliot
The Yeastie Beastie
Sore nipples can turn a good nursing relationship sour. If you have read everything and carefully checked the baby's positioning to make sure that isn't causing the pain then it's time to seek professional help. Contact a La Leche League Leader or Lactation Consultant, she should be able to check for correct positioning and rule out other causes of nipple soreness. If your nipples are pink and tender, flaky or itching suspect thrush and get to a sympathetic doctor, or dermatologist! The longer you wait the harder it can be to cure.
What Is Thrush?
Thrush is a yeast infection of the throat and mouth of an infant or the nipples of a nursing mother. Candida albicans is normally present in our bodies, but certain circumstances (such as stress, a weakened immune system or use of antibiotics or steroids) may cause it to reproduce wildly and colonize the vagina, intestines, diaper area, throat, mouth, nipples and/or skin folds of the host.
Possible Symptoms Of Thrush:
Red, irritated skin patches in the creases of the baby's neck, thighs, and arm pits; white patches and/or sores on the inside of the mouth, cheeks, or tongue; refusing the breast or a reluctance to nurse (due to pain); a white pasty discharge in the folds of the vagina; an angry red diaper rash (looks scalded) possibly with pinpoint sized bumps; baby may be irritable and gassy. The baby may also be without symptoms. A mother may have thrush on her nipples even if her baby has no sign of it!
Prolonged or sudden onset of sore nipples during or after the newborn period; a pinkish rash on the nipples or red, shiny nipples, itching, stinging or burning; cracked and possibly bleeding nipples if severe enough; feeling like there's razors or broken glass in the baby's mouth during feedings; pain when water from the shower hits the nipples; a vaginal yeast infection (or history of). An intense stabbing or burning pain in one or both breasts during or just after a feeding may indicate a secondary yeast infection has developed within the milk ducts (especially common with cracked nipples). NOTE: Nipple yeast may be combined with other causes of soreness such as eczema.
The sooner you catch this annoying little yeastie beastie the easier it will be to get rid of it. mother and baby both need to be treated for at least two weeks after all symptoms have cleared.
What can you do while you're waiting for the treatment to take effect? If the pain is really bad try these comfort tips:
- Rinse nipples with clear, cool water and air dry after every nursing, thrush thrives on moisture and the sugar (lactose) in breastmilk.
- Offer short, frequent feedings, nurse on the least sore side first (if there is one); if necessary, suspend nursing on a particularly sore breast for 24 hrs. (carefully hand express to prevent mastitis).
- Don't let baby slide off the nipple, make sure you break the suction first by inserting your (clean) finger in the corner of baby's mouth.
- Lansinoh for Breastfeeding Mothers heals & protects sore, cracked nipples.
Home Treatment:I don't like to take a lot of drugs but there is no substitute for prompt treatment when it comes to thrush. However there are some natural treatments for thrush that may speed your recovery (most are available through your local health food store or co-op):
- Yeast thrives in dark, moist places. Exposure to fresh air and sunlight is one of nature's best cures. Outdoors and naked for hours is most effective but even 10 minutes of sunlight through a window will work.
- Go braless as often as possible. I had thrush off & on for years, what finally got it to go away and stay away was when I quit wearing a bra.
- Keep baby's bum dry; let baby go diaperless as much as possible, eliminate rubber pants; use 100% wool or cotton covers (but limit time in them to when wet clothes would be unacceptable); change diapers promptly.
- Breast shells & nipple shields may contribute to yeast overgrowth - stop using them or, if you must use them, make sure to boil for them 20 minutes every day to kill the yeast.
- Use excellent hygiene. Wash you hands after you change baby's diapers, touch your nipples, or touch the baby's mouth. This will prevent the thrush from spreading.
- Use towels, bras and breast pads only once, wash in HOT water, and use 1/4 cup vinegar in the rinse water (for all your laundry) to help kill yeast - weather permitting hang them in the sun to dry (the sunlight kills yeast); same thing for diapers.
- Avoid dairy (except yogurt), sugar and yeast containing foods and supplements like the plague. Stay away from highly processed foods, baked goods, heavy starches, wheat, sugars, honey, fruit and fruit juices. Eat organic grown, fresh vegetables, meats, beans and whole grains while you are treating the infection. And, as always, drink plenty of distilled water to keep up your milk supply (a good guide is 1/2 oz/lb of body weight, more if you are very active).
Oral & Nipple Thrush:
- Gentian Violet solution, 1% swab on nipples and inside babies mouth once daily for up to four days, you should feel an improvement by the 3rd day, if not stop. May be used up to seven days if needed but no longer. NOTE: this remedy will stain everything purple (just like iodine stains things red) so wear old clothes.
- Lactobacillus acidophilus and/or Lactobacillus bifidus supplements (look for them in the coolers, most need to be refrigerated to maintain potency). Infants and toddlers should be given bifidus rather than acidophilus, there are many bifidus supplements made just for kids. Lactobacillus is a "friendly" bacteria that keeps yeast growth in check.
- yogurt, homemade is best but acidophilus yogurt is a close second. Eat it, smear it on your nipples, freeze small cubes of yogurt & let baby mouth them, coat the inside of your baby's mouth with it after each feeding - dip a clean finger in the yogurt and let your babe suck it off or smear the yeast patches with yogurt on a cotton swab (do not double dip, you will contaminate the yogurt - throw it away after 1 application!). Take special care not to contaminate your yogurt with thrush!
- Garlic, garlic, garlic! Use fresh garlic in your cooking or take a garlic supplement (unsolicited product endorsement: Try Kwai brand, orderless - extra potent).
- Rinse nipples with an organic, raw apple cider vinegar solution made from 1 tablespoon vinegar in 8 oz of water. WARNING: may sting if thrush is severe.
- Dissolve a level teaspoon of baking soda in 8 oz of water. Use a fresh cotton swab to wipe the insides of your baby's cheeks, gums, and tongue after every nursing - bathe your nipples after every nursing too. Make a fresh solution every day. WARNING: some health care providers worry about the baby ingesting too much salt with this method - use your judgement.
- large quantities of vitamin C (1 gram every 2 hours for a week or longer if immune system is very weak) is said to discourage the growth of yeast.
- Caprylic acid, taken according to directions.
- Grapefruit seed extract is supposed to be good for stubborn cases.
- Black Walnut (tincture), painted in baby's mouth and on mom's nipples 2-3 times a day. In stubborn cases mom can also take the tincture internally, 10 to 15 drops 2-3 times a day. Be careful near clothing, it stains!
- Pau d'Arco tea 2-3 cups daily. Pau d'Arco is a South American tree that resists fungus growth.
Yeast Diaper Rash:
- Some of the suggestions above will work (with some modification) for yeasty diaper rashes too, use your own judgement.
- For yeasty diaper rash rinse baby's bum with diluted Tea Tree Oil, (an anti-fungal, 3 drops to 1/3c. distilled water); some mothers have used this on their nipples too - please use with caution, as little as 1 tsp. taken internally can cause coma in children.
- Dust slippery elm bark powder into the folds of the thighs and arms, under the neck, and on the bum. It soothes and helps absorb moisture. Wash & reapply a couple times per day. In severe cases, add a pinch of goldenseal powder to each tablespoon of slippery elm to inhibit further yeast growth. Avoid cornstarch, as it will encourage yeast growth!
- Cut off oxygen supply to the yeast by completely coating your baby's diaper rash with egg whites, a loose slip of clay, or slippery elm gruel. Allow to air dry before diapering, reapply as needed.
- Use zinc ointment and Epsom salt baths to speed healing.
Candida Albicans Resources:
- Candida Protocol, Using Gentian Violet and Fluconazole (Diflucan) For the Treatment of Thrush: By Dr. Jack Newman: Dr. Newman is a pediatrician and a graduate of the University of Toronto medical school. He started the first hospital-based breastfeeding clinic in Canada in 1984. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa.
- Pat Gima’s Yeast Treatment Plan: Pat Gima has been working with breastfeeding mothers for 30 years, 15 of these years as a board certified lactation consultant. Because of a rise in the incidence of yeast infections in the newborn period, Pat has made the treatment of yeast/bacterial imbalance her specialty.
- Yeast (Thrush) and Nipple Pain: The Breastfeeding.com Answer Center
- La Leche League Internationals' FAQ on Thrush
- How to Fight Thrush and Win: by another mom who's been there.
- The Candida Page: an extensive listing of candida links
Natural Mothering: Thrush Page
First on-line: 6/28/1996