Yeast (Candida) is a micro-organism that normally lives in, or on, moist parts of the body - the mouth, intestinal tract, vagina, diaper area and feet. Under certain conditions, yeast can overgrow and cause discomfort for a breastfeeding mother and her baby.
Pregnancy (due to changes in hormones), antibiotic use (which changes the balance of normal bacteria in the intestines), fatigue, poor nutrition and illnesses (which stress the immune system) may all encourage an overgrowth of yeast in, and on, the body.
Yeast is difficult to culture, therefore, a diagnosis is made based upon symptoms. The overgrowth may resolve quickly, or it may be hard to decrease the yeast to a normal level for your body.
It is important to remember that painful red nipples may be caused by a baby’s latch or a breast pump. Pain from vasospasm is often confused with “yeast”, because it causes burning pain after feedings.
Possible Symptoms of a Yeast Overgrowth
- A burning or shooting pain in the nipple or breast during, or after, breastfeeding or pumping. The pain may radiate to the underarm or back and it may be worse at night.
- A painful latch, after weeks of pain-free nursing.
- Nipple redness, usually extending onto some of the areola.
- White patches in a baby’s mouth – they may look like milk, but do not wipe or rinse off.
- A bright red diaper rash, which does not go away.
Treatment of a Yeast Overgrowth
- 1% Gentian Violet is a very effective anti-fungal liquid that may be used to treat an overgrowth of yeast on a mother’s nipples. It may be applied ONCE A DAY or EVERY OTHER DAY to a mother’s nipples, after a feeding, for up to 3 times. While it is an over the counter medication, we recommend its use only with the guidance of a physician or a lactation consultant.
- You should notice an improvement in your symptoms within several hours of applying the Gentian Violet. If after two treatments, you do not notice any improvement, please let your physician or lactation consultant know. Yeast (Candida) is a micro-organism that normally lives in, or on, moist parts of the body - the mouth, intestinal tract, vagina, diaper area and feet. Under certain conditions, yeast can overgrow and cause discomfort for a breastfeeding mother and her baby.
- You may also apply clotrimazole to your nipples after feeding your baby (or pumping), except when you apply the Gentian Violet. Clotrimazole is an over the counter anti-fungal cream. Do not purchase the vaginal formula as it tends to expand when applied. You may continue applying clotrimazole to your nipples after a feeding twice a day for two weeks once you have stopped the Gentian Violet to help avoid re-growth of the yeast.
- To apply Gentian Violet: pour a small amount into a small clean disposable container (Dixie cup) and use a clean Q Tip to apply the solution to your nipples and the entire areola area. (If lanolin was applied recently to your nipples, the Gentian Violet may not absorb well.) The Gentian Violet will stain your skin. Please use caution as it is difficult to remove from fabric.
- We do not recommend that 1% Gentian Violet be applied directly to your baby’s mouth as it is irritating to mucous membranes. If your baby has visible thrush (a yeast overgrowth in their mouth), your baby may receive some benefit from the Gentian Violet treatment to your nipples.
- If you feel that your baby’s thrush requires additional treatment, you may talk to your baby’s physician about other treatment methods, including nystatin, a solution that is applied several times a day to baby’s mouth. A .5% Gentian Violet solution is less irritating to your baby’s mouth and may be obtained from a compound pharmacy with a physician’s order.
- Ibuprofen may help with nipple discomfort. You may take 400 mg every 4 hours (maximum 2400 mg/day) until the pain decreases.
- If your baby has visible thrush that is resistant to treatment AND uses a pacifier, you may want to purchase a new one and boil it daily until the problem is resolved.
- Oral supplements of probiotics can help limit the amount of yeast in your intestines. Take according to directions for two weeks beyond any symptoms to help prevent re-occurrence. You may also want to treat baby with probiotics formulated for infants if you are having difficulty clearing the thrush in baby’s mouth.
- If baby’s diaper area is red and inflamed, you may wash the diaper area with water and wipe down with a mixture of 1 T vinegar to 1 cup water. You may also apply Clotrimazole anti-fungal cream to your baby’s diaper area.