Thrush in Breastfeeding

Thrush in breastfeeding is a common problem that causes breast pain in mothers and feeding difficulty in babies. This yeast infection spreads easily and can be challenging to treat.

As a breastfeeding mother, going about this breastfeeding problem can be stressful. You may worry about a reduced milk supply, a weakened mother-baby bond, and painful breastfeeding.

Thrush symptoms can be uncomfortable and overwhelming, especially while managing your baby’s daily needs. However, it’s generally not harmful and doesn’t require you to stop breastfeeding during treatment.

What is Thrush in Breastfeeding?

Thrush is a yeast infection caused by an overgrowth of the fungus Candida albicans. This fungus is naturally present in the body and is usually harmless, but it can become problematic when it grows beyond normal levels.

Thrush survives in warm, dark, and moist environments. This means it can occur in places like your mouth (oral thrush), vagina, nipples, and breasts. ^[4]

Thrush during breastfeeding occurs when a yeast infection affects you, your baby, or both. You may experience nipple or breast pain, and the skin around your nipples might become red, dry, or flaky. In babies, thrush often appears in the mouth but can also affect the skin.

Since the baby's mouth and the mother's nipple are usually in contact during breastfeeding, this yeast infection can be passed back and forth between mother and child. So, either or both of you can be infected simultaneously.

Not all pain experienced during breastfeeding is caused by thrush. It’s important to recognize the specific signs of thrush-related breast pain to distinguish it from other causes and ensure proper treatment.

Thrush-related breast pain is usually different from typical breastfeeding discomfort. It often causes a burning or shooting pain deep in both breasts, even between feeds. In contrast, pain in only one breast or nipple is more likely due to other issues, such as a poor latch, blocked duct, or mastitis. If one breast feels warm and has a red, tender patch, it’s more likely to be mastitis rather than thrush.^[8].

Thrush-related pain does not come with fever or flu-like symptoms. Unlike latch-related pain, which typically occurs during feeding, thrush pain often begins after a feed and may persist for up to an hour.

Signs of Nipple Thrush During Breastfeeding 

A 2023 study published by the Journal of the American Academy of Dermatology identifies the signs of nipple thrush, including nipple pain, itchy nipples, burning sensation, and breast pain ^[10]. On the other hand, your breastfeeding baby can also develop thrush, but the symptoms are different for each of you. 

Thrush Symptoms in Mothers

Thrush often causes a range of noticeable and sometimes painful symptoms, even if breastfeeding has been comfortable until now ^[8]. If you suspect thrush, watch for the following signs:

• Sudden nipple or deep breast pain, even after a proper latch

• A burning, stinging, or shooting sensation in the nipples, especially after feeds

• Nipple color changes to a warm red patch or pink in lighter skin tones; dark brown, purple, grey, or ashen in darker skin tones.

• Itching, increased sensitivity, or tenderness in the nipple area.

• A fever that refuses to go away.

These symptoms can vary between individuals. If you notice these signs, consult a healthcare provider or lactation consultant for proper diagnosis and treatment.

Signs of Thrush in Babies (Oral Thrush)

Thrush in babies is typically referred to as oral thrush and is characterized by a yeast infection in the baby's mouth and skin. Oral baby thrush can cause soreness in your baby's mouth and pain while breastfeeding. Always check for signs of oral thrush in your baby to avoid feeding difficulties and dehydration ⁽¹³⁾.

• White patches that cannot be wiped off on the tongue, gums, or lips.

• Lack of interest in sucking due to soreness in the mouth.

• Signs of discomfort and irritation, such as crying and fussiness.

• Presence of red rash in the diaper area.

Oral thrush can lead to nipple thrush in mothers. As long as your baby sucks on the nipple, a connection is established between the mouth and your breast. This makes it possible for your baby to pass the infection to you. You and your baby should get treatment for thrush if one of you has it ^[6].

Difference Between Mastitis and Thrush During Breastfeeding

Mastitis is an inflammation of the breast, often caused by a bacterial infection, unlike thrush, which is caused by a fungal infection. Bacteria can enter through a cracked nipple or multiply if milk builds up due to a blocked duct or external pressure (such as a tight bra or baby carrier), leading to infection and swelling.

Recent research published by the Journal of Midwifery States that about 10-20% of women experience mastitis ^[11]. Therefore, it is also a likely cause of breast pain in some breastfeeding Moms, and symptoms in both thrush and mastitis are a bit different.

• Mastitis usually affects one breast, but thrush can affect both breasts.

• Mastitis often presents with flu-like symptoms, including fever, chills, vomiting, and body aches, while thrush causes burning, itching, and sharp breast pain.

• You might notice nipple discharge with mastitis, but thrush tends to cause shiny, cracked, or flaky nipples.

• A mastitis-affected breast may look red, swollen, and feel hot, while thrush can cause a red, shiny rash around the nipple.

• While thrush affects the nipples and the skin around them, mastitis affects the whole breast tissue.

What Causes Thrush in Breastfeeding

To prevent thrush-related difficulties in breastfeeding, you need to understand the causes of thrush in mothers and babies. 

A baby’s oral thrush may cause breast or nipple thrush in mothers. Through breastfeeding, yeast infection in babies can be contracted. However, a mother can also contribute to the risk of reinfection. Sometimes, babies develop oral thrush when they are exposed to vaginal yeast infections from the mother during delivery.

Recent research published by the National Library of Medicine highlights that vaginal infection during pregnancy can increase the risk of complications like miscarriage, premature labor, premature birth, and transfer of infection to the baby. As a result, infected pregnant mothers also contribute to oral thrush in babies ^[2].

The Centers for Disease Control and Prevention (CDC) explains that a weak immune system and some type of medication can contribute to the risk of having thrush during breastfeeding ^[1]. However, this breastfeeding problem can happen for several other reasons.

• The chances of thrush are higher with pregnancy.

• Thrush may be caused by recent intake of medications like antibiotics, steroids, and chemotherapy.

• Improper latch or positioning can cause nipple trauma, increasing the risk of thrush.

• Yeast thrives in warm, moist environments. Wearing tight or non-breathable bras and not allowing nipples to dry properly can encourage fungal growth.

• If the baby has oral thrush, the infection can pass back and forth between mother and baby during breastfeeding.

• It can occur when there are unique health conditions like HIV/AIDS, cancer, or diabetes that lower the immune system.

• The use of contraceptives like birth control pills may cause it.

• Thrush may happen if your skin (usually the moist part, like the armpit, under the breast, and buttocks area) is irritated.

While you can be infected through these causes, thrush is generally treatable. You should set aside all worries about thrush in breastfeeding and focus on how it can be treated when you notice thrush symptoms.

Remedies for Thrush During Breastfeeding

To treat breastfeeding-related thrush, start by checking for thrush symptoms in both you and your baby. Note that thrush treatment is not only for you; even your baby needs it. 

Both mom and baby need thrush treatment because this yeast infection is contagious. Once it affects you, it can spread to your baby through breastfeeding; the same goes for your baby. The main risk of treating one of you, and not both, is reinfection. It is advisable to go for treatment with your baby to stop thrush from coming back.

Home Remedies for Thrush During Breastfeeding

While home remedies should not replace medical treatment, several home remedies can relieve you of thrush symptoms. There are several common remedies for thrush in breastfeeding. 

Coconut Oil: Experts confirmed that coconut oil is active against Candida albicans, which suggests it could be a treatment for candida (thrush) ⁽²⁰⁾. Coconut oil is more than just a moisturiser; it enhances your skin's protective barrier functions. After each feed, gently smooth virgin coconut oil over your clean, dry nipples. It can help soothe that sharp sting, calm the itching, and ease cracked skin. It’s safe for your baby in small quantities and gentle enough for repeated use.

Apple cider vinegar (ACV): Apple cider vinegar (ACV) has an inhibitory effect against different bacterial strains ⁽¹⁹⁾. Its acetic acid may help inhibit fungal growth when applied to affected skin, making it a potential natural aid for treating thrush in breastfeeding mothers. Mix 1 tablespoon of ACV with 1 cup of cooled, boiled water, and dab the diluted solution gently onto your nipples using a clean cloth. Always rinse or wipe before nursing again.

Probiotics (Oral and Topical): Thrush often follows antibiotic use, which disrupts the natural balance of beneficial and pathogenic microbes in the body ⁽¹⁸⁾. Probiotics, especially strains like Lactobacillus acidophilus, can help reintroduce beneficial bacteria that compete with yeast, limiting its growth. Add a probiotic to your daily routine. It can help rebalance your gut and breast health, and even support your baby’s digestion. You should also lightly apply a baby-safe probiotic powder on your nipple or in your little one’s mouth before a feed (double-check with a lactation consultant first).

Proper Hygiene: As a breastfeeding mother, changing from a dry to a wet atmosphere can create favorable conditions for yeast overgrowth. Maintain good hygiene to help stop the infection from spreading or returning. Change breast pads frequently, wash bras and towels in hot water, wash and sterilise dummies, teats and any toys your baby may put in their mouth, and lastly, wash your hands thoroughly. These small steps reduce moisture and warmth, two conditions in which yeast thrives. ^[4]

Reduce Sugar Intake: Yeast feeds on sugar, so temporarily reducing your intake of processed sugars and refined carbohydrates may help slow its growth. While this alone won’t cure thrush, it can support your body’s recovery and make the environment less favourable for yeast overgrowth.

When to See a Doctor

While there are home remedies for thrush during breastfeeding that can make it leave naturally, you should know when to see a healthcare practitioner. You must see a doctor if you or your baby is showing signs of thrush infection.

• If you are unsure of your symptoms, you may need the help of your doctor because the breastfeeding phase is a critical stage for you and your baby. 

• If your symptoms continue after you have tried home remedies for thrush, this may be a clear sign to see the doctor. 

• White patches on your baby's tongue, lips, or gums could indicate a need for immediate medical intervention. 

• When your baby's nutrition, which will improve their development and well-being, is affected.

• If you have been diagnosed with thrush before, it may signal a challenging infection cycle. 

It is advisable to treat thrush symptoms at the same time as your baby for complete recovery.

Tips for Preventing Thrush in Breastfeeding

To prevent thrush and avoid reinfection while breastfeeding, it’s important to maintain good hygiene for both you and your baby. Since thrush is a common issue during breastfeeding, make it part of your routine to regularly check for early signs and symptoms.

The NHS has identified some tips to help prevent thrush and recurring infections. For the overall health of you and your baby, follow these essential tips for preventing thrush in breastfeeding ^[4] 

• Wash your hands thoroughly, especially after nappy changes.

• Do not use the same towel for your baby.

• Wash and sterilise all dummies, teats and toys your baby may put in their mouth.

• Change your pad frequently.

• Wash all clothes(you and your baby) or anything that come in contact with the infected area at a high temperature to kill the fungus.

• Reduce the frequency of sugar intake, as this can worsen it.

• Add probiotics like yogurt or supplements to your meal.

Do not overlook a healthcare provider's importance in treating thrush. If you have followed these thrush prevention tips and your thrush keeps coming back, consult your doctor.

Breastfeeding is an essential part of motherhood, and no matter what challenges it brings, be it thrush in breastfeeding or cluster feeding, it is just another phase that will surely pass.