For women who have ever dealt with the beast that is mastitis while breastfeeding, getting started on a treatment of antibiotics can be a literal lifesaver.

Unfortunately, however, a round of antibiotics to treat mastitis in a breastfeeding mother can also brings its own complications and lead to thrush.

So how can you safely treat this while breastfeeding?

Thrush is an overgrowth of yeast in the mouth; elsewhere on the body, it is simply called a yeast infection.

The fungus Candida (the main culprit of thrush)is actually totally normal and found on the body in many difference places. It only becomes a problem when it overgrows and causes thrush, or a yeast infection. You can have a yeast infection anywhere on your body and it’s common in places like the mouth, vagina, or, in nursing mothers, in the breasts. In case you hadn’t picked up on a trend there, yeast like a nice, moist place to grow. Yeast run wild when there’s an opportunity to grow with another body system compromised, like with an infection or a sickness that causes the immune system to be lowered.

Yeast infections are tricky. They can sometimes have no symptoms at all. In breastfeeding mothers, they can look like flaky skin on the nipples or reddened areas, but the telltale sign is excruciatingly painful, burning nipple pain or itchiness.

Many women don’t think that nipple pain has another cause, so a yeast infection can get missed as a diagnosis. It’s estimated that 18 percent of breastfeeding women in the United States who have nipple pain while nursing are actually experiencing a Candida infection.

Not all women with the Candida fungus will experience pain. The fungus can actually be present on a woman’s breast and nipple without her even realizing it, and may make her more at risk for developing mastitis, which then requires antibiotics, which then can make the yeast grow, and around and around she goes in a vicious circle.

But we do know that having a yeast infection on the breast can increase the risk of a woman getting mastitis, as the pain of feeding can cause the baby to latch improperly, lead to missed feedings, and cause nipples cracks or fissures that can allow bacteria to enter into the milk ducts.

Once the bacteria get into the duct system, it can cause mastitis.

So how do you treat yeast when it causes an infection on mom’s breast? Some of the medications used to treat yeast in mothers include the following.

  • Nystatin (Mycostatin), which is a cream that is applied directly to the affected area and can be used on babies as well.
  • One percent gentian violet in water, which involves “painting” the infant’s mouth before and after a feeding over a course of three to four days. This is a commonly used treatment, but there have been reports of side effects.
  • Fluconazole (Diflucan) is often prescribed for the mother and infant with severe cases of mastitis. The mother will receive a treatment for 10 days, while the baby will receive some medication through the breast milk, but will also need additional medication for 10 days as well.

To decrease the risk of yeast overgrowth on the skin, treat it, and prevent it from returning, it may also be helpful for women to avoid wearing breast pads that have plastic in them, as those trap moisture in and may promote the yeast growth.

Babies that have thrush sometimes have yeast in the diaper area as well, so it may be easier to figure out if your baby does have thrush. In the mouth, thrush will look like patches of white or yellowed skin and in the diaper area, a yeast infection can look like a normal diaper rash, with reddened, irritated areas of skin.

The treatment for the fungus will depend on where specifically the yeast infection is, but in the mouth, the most common medications given to treat thrush are Nystatin, Clotimazole, Fluconazole, or Itraconazole. In rare cases, the fungus can enter the bloodstream and cause serious complications, which will require hospitalization and more intensive IV medications for your baby.

To prevent and help treat fungal infections, make sure to change diapers frequently. Clean and sterilize all artificial nipples like pacifiers and bottle nipples while the yeast infection is being treated, since the fungus can live on moist, plastic surfaces and reinfect your baby.