Thrush (candidiasis or yeast) is a fungal infection caused by an overgrowth of the candida organism. Candida normally inhabits the mouth, gastrointestinal tract, and vagina, but can overrun almost any part of the body under the right conditions. For breastfeeding mothers this includes the breasts and nipples because thrush thrives in warm, moist conditions.
The first symptom of thrush is ususally pain. Many mothers describe the pain of thrush as a burning or stabbing pain in the nipple, the breast, or both. The pain may begin during a feeding and continue between feedings. Pumping is usually painful as well.
-Thrush may cause nipple itching or flaking, redness or shininess, or rarely, white spots on the nipple or areola. Sometimes there is a red or pink rash with small blisters on the nipple or areola.
-The mother may have a vaginal yeast infection or have had one.
-The baby may have signs of oral thrush; a "mother of pearl" look to the saliva or white patches in the mouth which look like leftover milk but will bleed if scraped.
-The baby may also have a bright red diaper rash that doesn't respond to usual treatments.
-The baby may be fussy or gassy or finding nursing uncomfortable or painful. The baby becomes fussy at the breast, refuses the breast, or comes "off and on" the breast frequently.
-It is important to note, however, that there may be no visible symptoms in either mother or the baby. Pain may be the only symptom.
An appointment should be made with a health care provider to confirm diagnosis. Possible treatments fall into three basic categories; medications requiring a physician's prescription, over-the-counter and herbal remedies, and home management techniques which work in conjunction with other forms of treatment. It is wise to treat both mother and child even if only one appears to be experiencing any symptoms.
Medications: If only the nipples appear to be involved, your health care provider may prescribe a topical antifungal (ointment or cream) to be used on the nipples. A liquid version also needs to be prescribed to treat the baby's mouth even of the baby is not exhibiting any symptoms.
Systemic antifungals may be prescribed if the milk ducts also appear to be involved or topical treatment has been unsuccessful. Many mothers find that a single dose is not effective. Sometimes treatment needs to continue for as long as 2 weeks.
Gentian violet is an antifungal that does not require a prescription but should not be used without consulting your healthcare provider as it can be dangerous if used improperly or for too long.
Herbs/Alternative Treatments: A vinegar and water solution (1 tablespoon vinegar to 1 cup water) is an easy ans effective treatment for nipples, especially when used in conjunction with other treatments. Apply to the nipples and areola.
Other Causes of Nipple/Breast Pain:
Positioning and latching problems should always be rules out when considering sources of pain. Other conditions can cause breast or nipple pain which may look like thrush. The conditions include but are not limited to: contact dermatitis, herpes, mastitis, eczema, psoriasis, poison ivy, ringworm, improper use of a breast pump, allergies, or nipple injury. Each of these should be considered especially when treatment for trush has been unsuccessfull.