Taming the Thrush Monster

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Once you’ve heard of thrush, trust me — you’ll know it when it finds you.

Feeling the drag of what must be broken glass shards from the top of your breast, downward and heavy through the bottom to the release of letdown? That’s thrush.

The experience of seeming white-hot razor blades slicing round and round your areola in sickening circular motion as baby nurses? That also can be thrush.

Seizing up with dread before every feed, knowing (and sweating bullets over) the least pain that might come, and imagining the worst that could, and that sometimes does come? Well, that too is a hand-walker with thrush.

In the first few weeks of breastfeeding (and again later in the first year after deciding not-so-smartly to pop my own milk bleb), I had that ‘broken glass’ deep in my breasts that moved slowly down into my nipples, aggressively dragged through by hormonal force.

Of course, I didn’t figure out its proper name, thrush, until after it spontaneously resolved itself four weeks later. It was a month of unremitting pain and silent torture, but I told no one other than The Designated Dad. I think we both felt that something could be wrong, but didn’t want to believe it. I didn’t feel confident enough to ask for help because what if this was normal? Would I then be viewed as a complainer? A bad mother? A weak infant caregiver?

I had expected that breastfeeding was just going to HURT, and yep, this really hurt so I thought: This must be what breastfeeding will be like until the final inning. I internalized the confusing and uncomfortable reality as “Well, this is the way it’s gonna be,” and decided to instead focus on my fright and apprehension on all the other strange new parenting conundrums that were dashing out at me like inexorable spirits from an ancient burial ground of newly awakened nurturing urges.

Honestly, I’m surprised I continued nursing through the untreated thrush at all. Smart to not quit over this hiccup — but rather silly to not entertain my need for assistance, advice, diagnosis, treatment, or assurance that nursing does not need to equal suffering… !

The look on little MaiTai’s face when he nursed was too divine (thankfully my case of thrush never affected him). And when he passed out after each feeding — he the total milk-drunk boob cherub — well, it was heavenly. Ain’t no way I’m taking this away from him, I thought. Broken glass moving like an elevator down my breast? Right, here we go…. again.

So now for the good news I wish I’d had back then: thrush is not only treatable, but also preventable for susceptible parties. Thrush can be persistent though, so you have to treat it much like that old burning flame who just refuses to gently fade away. Time to let this problem know: “You’re so yeast-erday!”

Okay, you don’t really have to say that. But here is what you should know:

Symptoms

Dr. Jack Newman describes what he has heard it feels like (emphasis mine):

Nipple pain that begins after a period of pain-free nursing. Though there are a few other causes of nipple pain that begin later, Candida infection is definitely the most common. The nipple pain of Candida may begin without an interval of pain-free nursing, however.
Burning nipple pain that continues throughout the feeding, sometimes continuing after the feeding is over, sometimes beginning in the middle of a feeding as baby is still drinking well.
Pain in the breast that is “shooting” or “burning” in nature and which goes through to the mother’s back and shoulder. This pain is usually worse toward the end of the feeding, and worsens still more after the feeding is over. It also tends to be much worse at night. This pain may occur without any nipple pain.”

La Leche League lists these symptoms of thrush in the mother:

“Pain.

Burning.

Itching.

Iridescent or shiny appearance.

Light-skinned mothers’ nipples may be red, purple-red or deep, angry pink.

Dark-skinned mothers’ nipples may be darker or red.

Nipples may be more erect than usual.

Nipples may be dry and may actually peel during or after a yeast infection.

Skin may have a rash with tiny, fluid-filled blisters.

Nipples may have white dots. Nipples may appear swollen.

Mother may have a vaginal yeast infection.

Sore or cracked nipples have not responded to changes in positioning other comfort measures.

One or both nipples may be affected.

Mother may have experienced recurrent breast infections or plugged ducts.”

These are the symptoms listed by La Leche League for thrush in the baby:

“Refuses to nurse.

Nurses and pulls off.

Gassy (windy) and cranky.

Makes clicking sound when nursing.

Yeast present in other places on body.

Red diaper rash that does not respond to soothing remedies.

[Mouth: Either perfectly normal; white patches that do not rub off; or pearly look to saliva].”

Not all symptoms need to be present. Your body may not react with the characteristic white patches as there are many types of the Candida yeast strain. (Both times I had thrush, I was not alerted by any white patches or blistering, and MaiTai displayed no physical or behavioral symptoms).

There’s no mistaking thrush pain, however. Unless, of course, you’re a newbie breastfeeder like I was and you assume the sharp jags through your breast during feedings are merely the subjects of those “breastfeeding hurts!” chants sung by seemingly everyone.

Causes & Prevention

An overgrowth of the bacteria Candida albicans is the usual culprit, but exposure to damp weather or fungi/molds can also be blamed for causing some cases of thrush.

Avoid antibiotics if you can as it disrupts your bacteria balance. (After processing my own first encounter with the thrush monster, I came to suspect the perpetrator had been a dose of unwanted and unneeded antibiotics sneaked into my IV line during labor without my knowledge, but of course I cannot easily prove this).

Expressed milk is okay to give the baby, but you may invite a thrush recurrence by giving the baby previously frozen milk that was expressed during a thrush episode.

Pregnant women are more susceptible to yeast, especially though who received antibiotics during pregnancy, labor or newly postpartum (for B-strep, allergic reaction, C-section, etc).

Women who use breast pads are more likely to develop yeast than those who don’t, as are those who are immuno-compromised or nutrient deficient.

Treatment

Don’t just check yourself for thrush! Both a mother and her baby should be treated for thrush for at least two weeks even if only one of them displays symptoms. Other members of the household such as siblings and the mother’s partner should assess their need for treatment, too.

Keep in mind that men often don’t show the telltale symptoms of thrush, so symptom-free does not necessarily equal ‘safe.’

A health-care provider can prescribe effective medication for breastfeeding thrush, such as Nystatin pills or fluconazole (Diflucan), which was originally designed to treat vaginal yeast.

For homeopathic types who wish to avoid drug side-effects, natural remedies work very well too:

  • Try the favorite standbys: vinegar rinse, tea tree oil, or gentian violet (in addition to All-Purpose Nipple Ointment).
  • Eliminating yeast-containing products, dairy, and sugar from your diet can help. Thrush multiplies quickly when sugar and yeast are present. Deodorant is also a favorite food for yeast bacteria so allow your pits to go primal for now. Add a probiotic (Lactobacillus acidophilus) supplement to restore good bacteria.
  • Coconut oil can also be used to combat drug-resistant species of Candida yeast. Olive oil applied to the nipples after each feeding may help to suffocate yeast with its linoleic acids. Do some research into the safety of oil of oregano as a treatment before committing to that popular option. Read more about the details of each treatment option here, or here for a long list of other natural immune-boosting options with specific directions for use.
  • If your baby uses pacifiers or bottles, you’ll need to boil them after each use to avoid spreading the yeast. The same goes for breast pump parts that touch the milk or breast, toys, utensils, and anything else baby puts in her mouth. La Leche League recommends to buy new ones after a week of treatment.
  • Keep your nipples as dry as possible as thrush thrives in moist environments. Don’t take a blow-dryer to your boobs, though — enjoying a ‘Go Topless Day’ for consistent fresh air is sufficient.
  • Basic hygiene: Disposable breast pads must be replaced frequently. Cloth pads should be washed in hot water between feedings as well. Consider temporarily switching to disposable diapers if you regularly use cloth.
  • Wash your hands often between diaper changes, feedings, etc. to prevent spreading the bacteria. Use warm water and regular soap; don’t overdo it with antibacterial soap and sanitizer because they’ll destroy the good bacteria that you need for recovery.

Resources

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