As an employer, you may have been privy to an occasional lunch room discussion, where a new mother, excited to breastfeed her infant, said that she gave up because it was too painful. Although there are various reasons for pain while nursing, thrush or oral thrush are sometimes overlooked. However, if diagnosed and treated early, both mother and baby can still enjoy the bonding and health benefits of breastfeeding.
What is Thrush?
Thrush is an infection caused by the fungus candidiasis albicans, and it often affects the elderly, babies, and those taking certain medications like antibiotics, as well as people with immune system deficiencies or underlying medical conditions, such as AIDS/HIV, diabetes or cancer. Thrush in the mouth is referred to as oral thrush.
Because thrush thrives on the yeast found in breast milk, a lactating woman’s nipples and milk ducts may become infected, causing thrush to develop in the baby’s mouth. An infant can also acquire thrush if the mother had a vaginal yeast infection at the time of delivery. A baby who has been on antibiotics could also get thrush in his or her oral cavity and infect the mother.
Who infected whom becomes a “chicken or the egg” scenario. But bottom line is that the mother is in pain and the baby may be hungry. So, to keep the infection from passing back and forth from mother and child, both need to be treated at the same time.
Nursing mothers infected with thrush often have some of the following symptoms:
- Intense nipple or breast pain, occurring throughout the feeding, even when the baby is repositioned
- Sudden bout of breast pain after an interval of pain-free nursing
- Pain when correctly using a breast pump
- Itchy, burning or cracked nipples or nipples that have a crusty rash or small blisters; however, in some cases the nipples appear normal
- Shooting pains deeper in the breast may be an indication the thrush has infected the milk ducts
- A vaginal yeast infection at the same time that thrush is affecting the breasts
Mothers are always on the lookout for diaper rash, but most don’t realize that it can be a sign their baby has thrush. Other symptoms may include:
- White patches inside the baby’s mouth and gums that cannot be wiped off
- Inside of the mouth looks shiny
- Refusing to take the breast or pulling off because of a sore mouth
- Repeated clicking while nursing
- Extreme gassiness from the yeast in the gut
- Some babies don’t have any visible signs at all but may be fussy and irritable
When nursing becomes painful, new mothers should contact their doctor. If thrush is diagnosed, both mother and baby will be treated at the same time for at least two weeks, but breastfeeding doesn’t have to stop. A topical medication, like nystatin, is usually prescribed in a liquid form for the baby’s mouth, and the cream version for the mother.
If thrush has infected the milk ducts or reoccurs after a full course of treatment, a pill version of nystatin may be necessary. And if the strain of thrush is resistant to nystatin, the doctor may prescribe other drugs, as well as suggest over-the-counter medications to use at the same time.
To prevent reinfection, mothers should boil the baby’s pacifier for 20 minutes each day and boil all breast pump parts that come in contact with milk. They should also wash all clothing (bras, bra pads, nightgowns) that come in contact with their nipples in hot water with bleach, and dry them in a hot dryer or the sun.
Rinsing their nipples with a solution of one tablespoon of vinegar to one cup of water after feeding, is helpful for many breastfeeding moms. However, a new solution should be mixed every day, using a clean cotton ball for each application.
Acidophilus supplements help some women, as does reducing yeast and sugar in their diet. But another important preventative is washing hands carefully after diaper changes, since babies can get yeasty diaper rashes.
Nursing should be an enjoyable experience for both mother and baby. But when a stint of thrush threatens to interfere, it’s reassuring for a new mom to know that she and her baby can be successfully treated. Moms-to-be who are anticipating breastfeeding, or those just getting started, can contact their local La Leche League for assistance and answers to all of their breastfeeding questions.