Modified
from: NEW BEGINNINGS, Vol. 10 No. 3, May-June
1993, pp. 83-4
Nancy Mohrbacher, Mt. Prospect, Illinois, USA
In the proper balance, yeast can be beneficial
to our bodies. However, when it becomes too
abundant, problems, such as thrush, can develop,
making breastfeeding painful. Candida albicans,
the organism that causes thrush, is a fungus
that thrives on milk on the nipples, in the
milk ducts, and in the baby's mouth.
In the baby, possible
symptoms of thrush include:
Diaper rash,
White patches on the inside of the mouth, cheeks,
or tongue,
Refusing the breast or a reluctance to nurse
(because baby's mouth is sore). The baby may
also be without symptoms. In other words, a
mother may have thrush on her nipples even if
her baby has no sign of it.
In the mother, possible
symptoms of thrush include:
Prolonged or sudden onset of sore nipples during
or after the
Newborn period (the nipples may be pink, flaky,
crusty, and itchy, or red and burning), cracked
nipples,
a vaginal yeast (monilial) infection.
An intense stabbing or burning pain in one or
both breasts during or shortly after feedings
may mean that a secondary yeast infection has
developed within the milk ducts. This seems
to be more common if mother or baby has been
on antibiotics (because antibiotics kill the
beneficial bacteria in the body that keep yeast
under control) or if the mother had cracked
nipples (the fungus can enter the breast through
the cracks).
Thrush is more likely to develop if either mother
or baby has been treated with antibiotics, the
mother's diet is high in sugars, the mother
has diabetes, or the mother's resistance is
low, due to fatigue or other health problems.
Although thrush is usually not serious, it can
definitely be a nuisance. In a few reported
cases, mothers have chosen to wean their babies
because of the severity and persistence of thrush.
Before reaching that point, however, a number
of steps can be taken to solve the problem.
Fortunately, the treatment for thrush need not
interfere with nursing.
Treating Thrush
The first step in treating thrush is to contact
a health-care provider. Mother and baby need
to be treated simultaneously for at least two
weeks, and breastfeeding need not be affected.
In Breastfeeding: A Guide for the Medical Profession,
Ruth Lawrence, MD, recommends doctors prescribe
liquid nystatin for the baby's mouth and a nystatin
cream for the mother to apply to her nipples
and areolae. Nystatin pills or liquid for the
mother may be necessary if deep breast pain
develops or if the thrush recurs after a full
course of treatment. Some strains of thrush
have become resistant to nystatin, so if the
nystatin does not bring relief, other drugs
may be necessary. Over-the-counter preparations
and other prescription drugs are available and
may be used on the recommendation of a health-care
professional. 
In mild cases of thrush, once treatment has
begun, relief may be felt in twenty-four to
forty-eight hours. In severe cases, the symptoms
may take three to five days to disappear. It
is important that the medication be continued
for the entire time recommended, since the thrush
may recur if the medication is stopped when
the symptoms disappear.
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Comfort Measures during
Treatment
When treatment for thrush is started, the symptoms
may seem worse for a day or two before they
improve. To help speed relief, try rinsing the
nipples with clear water and air-drying them
after each nursing, as thrush thrives on milk
and moisture.
Before the pain is gone, the following suggestions
may help make nursing more comfortable:
Offer short, frequent feedings,
Nurse first on the less sore side (if there
is one), and
Break the baby's suction before taking him off
the breast by gently pulling on the baby's chin
or by inserting your finger into the corner
of his mouth.
Preventing Recurrence
Thrush can be harbored in many places, including
milk. Once thrush has been confirmed, the following
precautions may help prevent recurrence: Wash
your hands often, especially after diaper changes
and after using the toilet. Expressed milk can
be fed to the baby, but milk expressed during
a thrush outbreak should not be saved and frozen.
Freezing deactivates yeast but does not kill
it. Therefore, if the frozen milk is given to
the baby after treatment is completed, it could
cause the thrush to recur. If the baby is old
enough to play with toys, anything the baby
puts into his mouth should be washed frequently
with hot, soapy water so that he does not re-infect
himself or spread thrush to other children.
Add Lactobacillus acidophilus to your diet to
re-colonize your digestive tract with the good
bacteria that can keep yeast in check. Consider
eliminating sugar, yeast-containing foods and
supplements, and other highly processed foods
from your diet. The yeast will not have anything
to feed on and you may find yourself healthier
and more disease resistant in general. 
In addition, men can have thrush without symptoms.
Thrush can be passed back and forth between
husband and wife during sexual relations. If
thrush continues to recur after mother and baby
have had two full courses of treatment, all
members of the family may need to be treated
simultaneously.
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