Breastfeeding creates an ideal environment for the development of thrush (oral candidiasis).
Thrush is a fungal infection that can adversely affect breastfeeding.
The cause of this disease is called Candida albicans - a single-celled organism (yeast), which is widespread in our environment and usually lives harmlessly in the mouth, gastrointestinal tract, skin and vagina.
Under certain conditions (immature or weakened immune system, damaged skin, hormonal changes, use of certain medications such as antibiotics or corticosteroids), fungal overgrowth can occur, leading to various forms of infection (candidiasis), including oral candidiasis, diaper rash. , rash on the breasts (nipples), vaginal candidiasis and others.
Many infants come into contact with these yeasts for the first time during birth (you may have vaginal candidiasis during pregnancy that you may not be aware of).
Breastfeeding creates an ideal environment for the development of thrush (oral candidiasis). The fungus thrives in a warm, humid and sugar-rich place, just like a baby's mouth during breastfeeding. Thus, the infection can also spread to your nipples.
Yeast is more easily retained on the breast if the nipples are cracked or inflamed (as a result of improper breastfeeding). If left untreated, the condition can be passed between you and the child.
Common signs of thrush in breastfeeding mothers are:
Both breasts are more likely to be affected unless the disease is at a very early stage.
If the baby has thrush, his oral cavity (the inside of the cheeks, gums, the roof of the mouth and the tongue) are covered with creamy white spots that resemble cottage cheese. These deposits cannot be removed (they cannot be washed). If you try to remove them, you may find that they are bleeding.
The infant often cries and drops the breast during feeding due to a painful sensation as a result of the inflammation.
Appearance of a dark red rash under the diapers. The affected area is very sensitive and painful, and the rash affects the genitals, legs (folds in these areas), but not the buttocks.
Keep in mind that some doctors will not prescribe concomitant therapy for you and your baby if you do not have symptoms. However, much of the literature says that this is crucial for complete recovery from the infection.
Treatment for both you and your baby should continue for at least 1-2 weeks after all symptoms have disappeared. Medications used for treatment are considered compatible with breastfeeding and do not require discontinuation.
To deal with the infection, your doctor will most likely prescribe an antifungal (antifungal) cream or gel (usually miconazole, nystatin ) to lubricate your nipples. Treatment should be continued for 2 weeks after the end of symptoms and can be given 4 times a day or after each meal (when using miconazole, it is usually applied to the nipples and areolas 2 to 4 times a day for 7 days).
It is necessary to apply the medicine on the nipples after each feeding and to remove it immediately before the next feeding of the baby. If your nipples are very red and sore, you may need to use a steroid cream to help with the treatment.
If this therapy is not effective and the infection spreads to the milk ducts, you will probably need to take an oral medicine (Diflucan).
Diflucan (fluconazole) is usually very effective against yeast when taken orally. The dose is 200-400 mg on the first day, followed by 100-200 mg for 10-14 days. Very little of this medicine passes into breast milk, so the amount to which the baby will be exposed is negligible. Diflucan should only be taken with a prescription.
Once treatment is started, symptoms may worsen for a few more days before they improve. While the pain persists, offer the baby to breastfeed more often, for a shorter time, starting with the less painful breast. Remember to wash the nipples and dry the nipples after each meal.
For the infant, the doctor most often prescribes Nystatin. The drug is applied to white plaques with an applicator or finger, several times a day for at least 10 days. Remember to administer the medicine after breastfeeding so that it stays in the baby's mouth for a longer time. It may take about a week for the infection to pass.
To relieve chest pain, you can take a mild painkiller paracetamol or ibuprofen every 6 hours (maximum 1200 mg for 24 hours).
You could also take probiotics to help the "good" gut bacteria suppress the fungal infection. Take them in pill form or consume yogurt directly. But don't rely entirely on it as a way to heal. Antifungal treatment prescribed by a doctor is the most effective way to get rid of thrush.
Garlic - as a powerful natural antibiotic. You can take 4 to 6 capsules of odorless garlic during the infection and within 1-2 weeks after the symptoms disappear.
Echinacea - an herb that stimulates the immune system. Taking echinacea during this period would also have a beneficial effect.
Vinegar solution with water - stew the nipples with water and vinegar (1 tablespoon of vinegar in 1 cup of water) after each feeding. Use a separate cotton swab for each bean and prepare a new mixture every day. Apply the solution after each breastfeeding and before applying the creams. The fungus cannot survive in an acidic environment.
The solution can also be used in babies with a diaper rash caused by the fungus. In these cases, it is good to avoid diapers as much as possible. It is also preferable to use cloth diapers.
Grapefruit seed extract - this remedy can be added to the therapy in a dose of 250 mg capsules or in liquid form three times a day.
Gentian violet - this tool is regaining its popularity more and more. For many years it has been known and extremely effective in the fight against yeast. Used in the area of the nipples and areola once a day (preferably at night after the last breastfeeding). It is applied with cotton swabs, which are soaked with the solution and the affected area is smeared. It is necessary to use separate and disposable tampons for both breasts.
The solution can also be used to shower (once a day) on the affected areas in the baby's mouth. Again, a disposable swab is used.
Some mothers worry that gentian violet contains alcohol and believe that it should not be used by nursing mothers. Keep in mind that the amount of alcohol in the solution is negligible and the baby swallows very little of it. If your worries still prevail, you can apply it diluted with water.
Apply for 4 days. If the symptoms improve but do not completely disappear, you can continue for another 3 days (but do not use for more than a week). If it is necessary to continue treatment after a week, you will need to take a break for a few days, then resume its use. If symptoms do not improve or worsen during the first 4 days of use, stop using the solution and seek advice from a consultant or doctor.
What you need to know about the gentian violet solution is that it stains the tissues bright purple. Be prepared to see your baby's mouth colored this way.
Applying it on the chest, it will be good to wear older clothes, as this product colors everything that comes into contact with it.
Creams prepared in the pharmacy - sometimes the doctor has to prescribe a combination of antifungals, antibiotics and steroids. Then it is necessary to visit a pharmacy where pharmacists prepare products at the moment. There you will be prepared a cream that is applied to the nipples after each breastfeeding (as before applying the cream you must wash and dry your breasts). An example recipe for such a cream includes:
Apart from the medicines you will take, there are other things you can do to fight the infection and avoid re-infection:
Yes! Breastfeeding can and should continue during treatment. Thrush should not stop it, although it can make it very painful. In mild cases, relief may be felt within 48 hours of starting therapy. In severe cases, it will take 3-5 days to notice any improvement. Symptoms may even begin to worsen for a day or two, after which improvement begins. When the infection has not been treated properly; is not diagnosed quickly enough or the fungus is particularly persistent, relief may not occur for several days and a combination of different medications may be needed. Treatment can be aggressive with changes in diet and boosting the immune system even after all symptoms have disappeared.
If breastfeeding is too painful, you could express breast milk during treatment days (this may be an easier and less painful option). Expressing should be as frequent as the baby is fed so that lactation is maintained. If the baby is under 4-6 weeks old, you can try to offer expressed milk in different ways (spoon, dropper, syringe) to reduce the risk of subsequent breastfeeding. Babies are easily accustomed to a bottle, as sucking from it is much easier than breastfeeding.
Feel free to feed the baby expressed milk, but do not freeze it. Discard what you have not used, as freezing does not kill the fungus. Therefore, expressed and frozen milk can be a source of new infection.
Breast milk can actually help protect the baby from fungal overgrowth, as some studies show a higher incidence of thrush in infants who are fed formula. The components of human milk, including type A secretory immunoglobulin (sIgA) and lactoferrin, that are active against Candida. In fact, because breast milk inhibits the growth of the fungus, it can be difficult to cultivate it in milk without the use of special techniques. In addition, breast milk creates favorable conditions for promoting the growth of "good bacteria" in the baby's gastrointestinal tract. Which in turn helps to limit the growth of the fungus.