Conquering Thrush for Blissful Breastfeeding RSandeman IBCLC

Many of my consults have had a common theme. Thrush! So I thought I’d have a chat with you about nipple and ductal thrush in breastfeeding mothers and their babies.

Mums initially contact me with nipple pain, when previously they have been traveling quite nicely without any issues at all. Or otherwise, I am finding thrush is disguised by nipple damage, or often mum is fine yet baby has suddenly started becoming fussy at the breast and they don’t know what’s going on.

This is where it’s important to put on my detective hat and do a thorough assessment of both Mum and Bub and ask all the right questions!

Signs Of Thrush In Babies

Fussiness at the breast
Slipping on and off, causing nipple pain
The development of clicking sounds when feeding
A white coating on their little tongue or white patchy spots on their palate or gums
Occasionally they may also have thrush in the nappy region and present with a nasty-looking rash.

It’s no wonder they feel quite uncomfortable and become fussy!

Symptoms Of Thrush For Mothers

Burning or itching nipples
Flaking or shiny skin on nipple or areola
Painful breasts without tender spots or sore lumps
Stabbing pain in the breast behind the areola
Shooting pain up through the breast
Pain persists throughout a feed and also in between feeding.

Factors That Contribute To Nipple Thrush

Antibiotic or corticosteroid use
Vaginal thrush
Other family members with athlete’s foot, jock itch, or nappy rash
Contraceptive pill
Bottle use in the first two weeks after birth
Diabetes
Dummy use
Anaemia

How To Help Prevent The Spread Of Thrush

Good, regular hand washing, especially after the toilet! Since COVID struck, we are all getting very good at washing our hands (hopefully!)
Keep nipples dry and avoid breast pads if possible, otherwise, change them regularly
Use disposable for once-off use only or change reusable every feed and wash in high temperature and wear clean
Breathable cotton bras
Use separate towels for each member of the family
Sterilize anything that comes into contact with the baby’s mouth such as toys or dummies or breast pump equipment
Replace toothbrushes and other toiletries
Candida albicans (the fancy term for thrush) do not survive in very acidic conditions so adding 1/2-1 cup of distilled white vinegar to baths or the washing machine can help stop the spread in its tracks

Diet can play a big part in the development of Candida Albicans, and its important to eat well-balanced nutritional foods, drink plenty of water, avoid carbs and sugars (shouldn’t we all!) and foods that tend to make it worse such as mushrooms, bread, dairy products, alcohol, and artificial sweeteners.

Artificial formula has high levels of iron which can increase thrush so it’s best to avoid it. Herbal products and essential oils are not properly researched on babies so aren’t recommended.

Treatment Of Thrush

It’s important to discuss with your doctor or lactation consultant about prescribed medication and what’s going to be best for you and your baby
Treat you and your baby simultaneously as thrush is transmissible from your baby’s mouth to your nipple and visa versa
Completing a course of medication prescribed by your doctor correctly is very important
Breastfeeding should be continued as normal during treatment to maintain supply and nourishment for baby
If this is difficult due to pain, the use of painkillers can be helpful, and use a breast pump to maintain your milk supply

Need Help With Thrush Or Feeding Issues?

Contact me for a breastfeeding consultation to help you nut out your nipple pain before starting medication that may be unnecessary- I can visit you in your home in Melbourne, or video calls are available.