Candida and Breastfeeding

Candida is also called yeast, monilla or thrush. It is a fungus that is naturally on and in our bodies. Candida lives in warm, dark and moist places such as the mucus membranes of the mouth, vagina, diaper area, skin folds, nursing bra pads and on wet nipples. Using antibiotics helps yeast grow because antibiotics kill off the good germs in our body. Yeast infections are more common in pregnancy and people with diabetes. Yeast infections may also lead to plugged ducts (channels for milk to flow in) and an inflammation of the breast (mastitis) and can even form an abscess.

Because yeast grows in warm, moist areas, it can be passed back and forth between a mom and her baby. Both mother and baby may need treatment at the same time in order to clear up the infection. It is important to do this even if one of you does not have symptoms. Occasionally, other family members (especially your sexual partner) may need to be treated at the same time.

SYMPTOMS

  • Severe stinging or burning pain, which may be on the surface of the nipples or may be felt deep inside the breast.

  • Pain during, in between or especially right after feedings.

  • Sometimes sharp, shooting pain spreads (radiates) from the nipple into the breast or into the back or arm.

  • Nipples are sensitive to touch and may have pain with even light touch. Nipples may also be:

  • Puffy.

  • Weepy.

  • Itchy.

  • Blistering.

  • Scaly.

  • Inflamed (reddish).

  • Flaky.

  • Painful.

If you or your baby have any of the symptoms described above, especially if you have been on antibiotics, or if your nipples suddenly become sore after the first two weeks after birth, you may have a yeast infection.

DIAGNOSIS

  • The diagnosis of yeast is often made based on the symptoms.

  • Microscopic evaluation of the breast discharge or cultures may be needed.

TREATMENT

  • Talk to your caregiver before starting treatment. It is important to begin treatment only after making sure other problems are not the cause of the problem.

  • Apply the antifungal cream that your caregiver gives you.

  • Wash your nipples with warm water before nursing the baby.

  • You may be advised to stop nursing from the affected breast and use a breast pump on it.

  • Keep the affected breast empty of milk with nursing or with a breast pump.

  • If your baby has thrush or diaper rash, treat it with medication prescribed by your caregiver.

  • If you are nursing and you have Candida, your baby should be treated for thrush even if you cannot see any white patches in the baby's mouth.

HOME CARE INSTRUCTIONS

  • Take medications as directed. If you have a ductal yeast infection, you may be prescribed medications by mouth. Make sure to finish all your medications. Make sure your baby is also seen and treated at the same time and finishes their medications as directed.

  • Wash hands often. This should be done before and after nursing, after using the bathroom and before or after changing the baby's diaper. Use hot, soapy water and soft towels or cloths to pat dry.

  • Nurse more often, but for shorter times. Start nursing on the least sore side. Numbing the nipple with ice wrapped in a washcloth before nursing may help.

  • If nursing becomes too painful, you may want to pump your milk temporarily and feed it to your baby by cup or bottle until the pain lessens.  

  • Eat a lot of yogurt that has live active cultures and take oral acidophilus.

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • Use creams or ointments as suggested by your caregiver.

  • Usually after 24-48 hours, you should feel some improvement. In some cases, symptoms may get worse before they get better. Continue treatment for at least 48 hours.

  • Air dry your nipples after nursing.

  • Change bra pads after each feeding.

  • Wear 100% cotton bras and wash them every day in hot water.

  • Wash your breast pump and all its parts thoroughly in a bleach solution and boil them in water for 5 minutes every day.

  • Consult your caregiver if you do not get better. Oral medications can be prescribed that may be helpful.

SEEK MEDICAL CARE IF:

  • You feel you or the baby are not getting better or getting worse with the treatment.

  • You have just taken antibiotics and your breasts develop shooting pains, discomfort, itching or burning.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • You develop swelling and severe pain in your breast.

  • You develop blisters on your breast.

  • You feel a lump in your breast, with or without pain.

  • Your nipple starts bleeding.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.