Yeast infections are miserable in every sense of the word. This pesty fungal infection can cause irritation almost everywhere in your body, and unfortunately once you get it, it is very difficult to get rid of. These fungal spores set up shop wherever there are areas of moisture. Although most commonly found in the vaginal canal, now that your breastfeeding; the breast, nipple and areola are perfect breeding grounds for this unfortunate condition. More often then not, the infection is well under way before a diagnosis is even made. The longer it spreads the more the fungus can wreak havoc on both you and your baby.
Yeast, formally known as Candida, is the most common fungal infection in humans. Mammary candida is a yeast infection of the breast. Thrush, is a yeast infection that is located in the mouth. Generally both mom and baby are infected and are continuously spreading the fungus back and forth to each other. It is recommended that both mother and baby will need to be treated simultaneously in order to fully kill the infection. To properly diagnose this condition both mother and infant should be seen by their primary care physician. Diagnoses is made from signs, symptoms and clinical suspicion of the doctor. If mother is experiencing symptoms and baby has yet to, it is still recommended for both to be treated and vise versus.
Some predisposing factors to mammary candida are:
- Baby who has been diagnosed with thrush, or fungal diaper rash
- Previous history of vaginal yeast infections
- Recent antibiotic therapy
- Nipple damage
- Heavy consumption of dairy products, heavily sweetened foods and/or artificial sweeteners
- Recent use of corticosteroid therapy
Symptoms of yeast in the baby include:
- White patches on the gums, cheek or tongue. (white coating on the tongue does not automatically mean thrush. A pediatrician should be called to officially diagnose)
- Persistent frequent gas
- Red diaper rash, with raised “Pimple” like bumps that do not clear up with standard diaper rash ointment
- Frequently irritable infant, that is continuously coming on and off the breast during a feed
Symptoms of yeast in the mother include:
- Burning sensation on the nipple during or after a feeding
- Sharp, shooting pains in the breast itself during or after a feeding
- Bright pink or red nipples
- Shiny red areola
- Shiny small “paper cut looking’ abrasions at the base of the nipple
Steps for treatment of a yeast infection on the breast:
- Continue to Breastfeed your baby, no interruption is necessary
- Referral to Obstetrician, family practitioner, or pediatrician for official diagnosis
- Oral Diflucan should be prescribed to treat the systematic yeast within the ductile system. (200-400mg STAT, then decreased 100-200mg daily for 14-21 days)
- Topical anti-fungal ointment such as Myconazole or Gyne-Lotrimin or AF Fungal cream should be liberally placed on the nipple and areola after each feed. Be sure to wipe the ointment off the breast with a warm wet wash cloth before feeding the baby. Once the baby has been fed, re-apply the fungal cream. However, if you are using Nystatin Cream in place of the above listed ointments, it is not necessary to wipe the ointment off prior to feeding. The baby will most likely be treated with the same ointment, so therefore it is perfectly safe.
- If baby is being treated with oral Nystatin, be sure to shake the bottle first, thoroughly mixing before using
- Use a gauze pad or Q-tip with warm water to gently wipe the baby’s mouth after each feeding followed by the prescribed medication.
- Gently wipe nipple and areola with warm water after each feeding prior to re-applying the prescribed medicated ointment.
- Once treatment has begun, you should begin to feel relief in 24-48 hours. In some cases, the symptoms may take up to 3-5 days or longer before relief is felt. Be sure to take the medication for the full course, since the thrush may recur if you stop the medication simply because symptoms begin to disappear.
- Pain medication may be helpful, such as Ibuprofen (400mg-600mg depending on weight) every 4-6 hours as needed for breast pain. Ant-inflammatory medication should be taken with food. Consult your health care provider for proper dosing.
- Begin taking probiotics. 1-2 capsules within 1 hour after a meal of Mega Acidophilus. (1.5 billion live cells per capsule, milk free, hypoallergenic, no sugar, starch, artificial colors or flavors, no corn, wheat , soy or dairy)
- Baby may be more fussy, gassy, and demand more frequent shorter feedings. Look for babies cues throughout treatment
- While mother and baby are being treated for a yeast/candida infection, fresh expressed breast milk or refrigerated milk can be fed to the baby in the absence of the mother, with no problem. However milk that has been expressed and stored during the outbreak of yeast should NOT be given to the baby on a later date as the fungal spores could reinfect the baby. Only when treatment is ongoing can infected milk be provided without any problems.
- Please keep in mind that it is very important to continue treatment for 1-2 weeks after thrush/candida symptoms have subsided in order to fully kill all infection.
Steps for preventing yeast from returning:
- Consider limiting your sugar intake and restrict alcohol, cheese, wheat and flour products
- Begin eating plain, unsweetened yogurt (Yoplait doesn’t help. There is too much sugar added to flavored yogurts, that it often counter acts the acidophilus properties)
- Continue taking pre-natal vitamins daily. Check to make sure your diet is not deficient in zinc, copper, vitamin A or B
- Add garlic into your diet which may boost the immune system and keep the yeast in check
- Avoid constant moisture on your nipples and areola. If you constantly leak breast milk, consider wearing cotton pads rather then plastic lined breast pads. DO NOT WEAR PLASTIC SHELLS
- Sunlight and yeast are mortal enemies! Sunbathe your nipples for 10 minutes, twice a day. Expose all undergarments, and breastfeeding equipment with direct contact to the breasts to sunlight.
- Take 1 tablespoon of vinegar to 1 cup of tepid water, and apply to nipples and areola with a clean cotton ball after each feeding to prevent fungal growth.
- Avoid restrictive clothing or under wire bras.
- Boil all pump parts, pacifiers, bottle nipples, nipple shields, and toys with direct contact to the mouth daily for 20 minutes until yeast is gone
- Discard and replace pacifiers, bottle nipples each week if needed
- Good hand washing is VERY important for both you and your baby to prevent further spread of the infection
- Increase rest decrease stress….(I know this is sometimes easier said then done!)
- Wash all clothing, towels, and undergarments that come in contact with yeast in HOT water.
If symptoms persist contact your health care provider and Lactation Consultant for further evaluation. There may be an underlying condition causing yeast like symptoms. Best of luck! For further information please see the following link from Dr. Jack Newman’s Candida protocol
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