Nipple thrush refers to a fungal condition that causes itchy, flaky skin on the breast. If you’re nursing, this can lead to oral thrush in your baby. OTC and prescription topical antifungals and antifungal mouthwash can provide relief.
Nipple thrush and oral thrush go hand-in-hand when it comes to breastfeeding. The most common causes of these infections are types of Candida yeast that live naturally in and on our bodies. While yeast infections can happen anywhere, the most common areas of the body involved are the mouth, groin, and areas where skin is covered and constantly rubbing against itself.
If you’re experiencing nipple thrush, breastfeeding a baby who has oral thrush, and looking to prevent or break the cycle of thrush infection and soothe symptoms, keep reading.
Symptoms of nipple thrush include:
- itchy, flaky, or shiny skin on the areola or nipples
- red or cracked nipples
- stabbing feeling deep within your breasts during or between feedings
Symptoms of oral thrush for a baby include:
- raised white lesions on the tongue or inside of cheeks
- redness or irritation around lips
- bleeding or cracking on lips
It’s also possible the baby won’t have any symptoms.
If you are breastfeeding and you or your baby develop thrush, you will both need treatment. You can keep breastfeeding while you treat nipple thrush, according to the La Leche League, International.
Yeast cells, the basis of nipple thrush and other yeast infections, can be passed to others by skin-to-skin contact. In most cases, this doesn’t cause an infection to happen, but this ease of transfer is what makes it so important to treat thrush. Watch for symptoms of yeast infections in other members of your household.
Conventional treatment for thrush in breastfeeding moms and babies includes a topical antifungal cream for your nipples and an oral rinse for your child. Continue treatment as directed by your doctor. When you’re breastfeeding, you should clear all over-the-counter (OTC) treatments for you and for your baby with your child’s pediatrician.
Common antifungals used to treat nipple and oral thrush include:
Topical antifungals for you:
Oral antifungal for you:
Antifungal treatment for baby:
- nystatin oral suspension
- gentian violet (but can cause irritation and ulceration)
- oral fluconazole
Coupling topical and oral medications with practical changes to your day-to-day life may be a better treatment than medication alone.
At-home steps for treating a yeast infection include:
- Wash clothing and linens in high heat. Laundering all shared surfaces that could harbor yeast, such as diaper changing areas, bedding, and bibs. Make sure to wash these things separately from other clothing. Consider adding bleach or distilled white vinegar to the wash.
- Regularly clean items. Thoroughly cleaning all pacifiers, sippy cups, breast pump parts, nipple shields, teethers, and toys, using hot, soapy water. Anything that comes into contact with the baby’s mouth or your breasts while you have thrush should be cleaned directly after use.
- Everyone should wash their hands. Everyone in the household and who cares for the baby should be extra careful to wash their hands regularly. Be extra mindful to carefully wash hands after changing the baby’s diaper. Wash your hands before and after nursing and applying any ointments to your breasts.
Other things you can try to manage or reduce nipple thrush include:
- Cut back on sugar. Consider reducing the amount of sugar in your diet, as yeast feeds on sugar.
- Add a probiotic to your diet to restore balance to the flora and bacteria in your system. Read more about probiotics and yeast infections.
- Use a diluted vinegar solution topically on your nipples in between feedings, as long as your nipples aren’t cracked or bleeding. La Leche League International recommends a ratio of 1 tablespoon vinegar to 1 cup of water. They recommend apple cider vinegar for your yeast infection. ACV is known as an antifungal. In a 2018
study, ACV was shown to have antifungal abilities in a petri dish. Though these findings haven’t yet been reproduced in humans, ACV will likely not cause you any harm to try. However, do not use ACV to replace the prescription your physician has given you.
If thrush persists beyond a month after treatment begins, speak to your doctor. It may be that a partner or another family member is reinfecting you or your baby with thrush and making it hard to get rid of. It may also be another factor that you haven’t considered.
When you’re breastfeeding, nipple thrush shouldn’t be left untreated. Oral thrush can move into your baby’s esophagus and cause other complications.
Taking antibiotics or having a lowered immune system can cause an environment in the body that makes it easier for yeast to grow and cause an infection. Other times, there is no initial cause or the cause is unclear. Since yeast grows in moist, warm environments, mouths and nipples are prime places for yeast to overgrow during breastfeeding.
Since yeast cells can be transferred by skin-to-skin contact, if your baby has oral thrush or another type of yeast infection, your baby can transmit thrush to your nipple while breastfeeding. In some instances, this becomes a cycle of infection where you transmit the yeast infection back and forth to each other.
- Pregnancy and nursing can cause your skin to rub against itself in ways you aren’t used to.
- Some people also sweat more during pregnancy.
- Wearing bras and tops that aren’t designed for nursing or pregnancy can also contribute by trapping sweat and moisture in the folds of your skin.
- Heat and humidity where you live can also make thrush infections more common.
Try to keep your breasts dry. Strategies to keep your nipples and breasts dry include:
Wash and towel dry. Rinsing your skin and drying the area around and under your breasts after sweating or after breastfeeding the baby may help reduce nipple thrush symptoms or prevent its return.
Air dry. After patting your chest with a clean towel, air dry your breasts. Some people use a hair dryer on a very low setting.
Yeast infections in the area of your nipples and breasts are common during breastfeeding.
Thrush on your nipples can be persistent and difficult to get rid of. You may need a combination of topical creams, home remedies, and a good dose of patience to treat nipple thrush effectively. Remember that taking care of yourself is a way to take care of your baby.