Thrush can be very difficult to treat. Check with your health care professional about thrush treatment options.
The fungus Candida albicans causes thrush. Everyone has this fungus in their body and it's a natural part of the digestive system. Generally bacteria keep bodily fungi at healthy levels. Sometimes thrush gets a chance to grow and it spreads easily and thrives in warm moist settings like your baby's mouth and your nipples. To prevent re-infection, both you and your baby need to be treated at the same time even if only one shows symptoms of thrush.
Treatment should continue for 2 weeks beyond the end of the symptoms and may be given 4 times a day or after every feeding. Both you and your baby should be treated after each feeding because this is when the yeast organism moves between baby and mom. Once thrush treatment begins, the symptoms may seem to get worse for a couple of days before improving.
Eating sugary foods, taking antibiotics, getting inadequate rest, stress, allergies, and injury to the nipples from poor positioning can also set up ideal conditions for fungal infection.
Signs of thrush - moms
Some mothers don’t show any signs of infection and do not experience pain.
Sudden onset of breast or nipple pain after pain-free breastfeeding.
Itchy or extra sensitive nipple.
Shooting, sometimes deep, breast pains after feeding that may last for up to an hour after the feed.
Cracked nipples that don't heal.
Paleness of the nipple or areola.
Signs of thrush - babies
Creamy white patches in baby’s mouth or on tongue or in the cheeks which do not rub off.
White glossiness on the baby’s tongue that cannot be wiped off.
Baby pulls away from the breast during feedings and seems unhappy or uncomfortable.
Diaper rash; usually red spots that don’t seem to heal.
Thrush Treatment for Moms
For breast painTake acetaminophen for example Tylenol or ibuprofen such as Advil.
Use ice packs on the nipples before feeding.Massage breasts to stimulate milk flow.
Offer your baby short, frequent feedings, beginning on the less painful side.
Make sure your baby is properly latched on when nursing and nurse your baby in the tummy-to-tummy position to create a straight latch and reduce pulling on the nipple.
Break the suction with your finger to gently detach baby from your breast.
Rinse your nipples and let them air dry after each feeding.
Avoid using breast pads because they make a warm, moist place for yeast to thrive.
Thrush Treatment – TopicalCreams and ointments such as Mycostatin and Lotrimin Antifungal Cream are available over the counter. Other treatments such as Nizoral ketaconazole cream or clotrimazole betamethasone cream may be available by prescription only.
Miconazole Over-the-counter creams and ointments include Micatin Antifungal Cream and Monistat Treatment Cream should be applied to nipples and areolas 2 to 4 times a day for 7 days. Miconazole oral gel is not designed to penetrate the skin of the nipple and is unlikely to be effective. Miconazole cream 2% applied sparingly to the nipples is preferable. Thrush on the nipple can be treated by spreading a small amount of miconazole cream after each feed. Any cream which can be seen should be gently wiped off before the next feed – taking care not to cause further damage to your nipples with vigorous washing.
ClotrimazoleOver-the-counter Clotrimazole include Mycelex, and Lotrimin and should be applied to nipples and areolas after feedings 2 to 4 times a day for at least 2 days AFTER symptoms have disappeared.
Nystatin Nystatin suspension is not pharmacologically intended to penetrate the skin of the nipple and is unlikely to be effective in thrush treatment of the nipple. There are also strains of Nystatin-resistant yeast.
Gentian violetThis can be used as a SHORT-term thrush treatment to treat nipples.
Thrush Treatment – Oral
Diflucan (fluconazole)Diflucan is an oral antifungal medication for stubborn and resistant yeast infections. Diflucan is currently used in a single application dosage to treat vaginal yeast infections. Thrush that has penetrated the milk ducts sometimes results in deep breast pain that lasts for long periods after feeds. The common treatment is fluconazole. The World Health Organization distinguishes fluconazole as a drug that is compatible with breastfeeding even though it is not licensed to be given to breastfeeding women.
A dosage of at least 100 milligrams per day for 14 days is necessary in order to be effective against ductal or systemic yeast. Some doctors use a first dose of 200 milligrams.
AcidophilusSome women take Acidophilus tablet supplements which are probiotics everyday as prevention or in addition to thrush treatment by helping to restore bacteria that can keep thrush under control.
Thrush Treatment for Babies
Miconazole A 5ml spoonful of miconazole oral gel should be used to cover all surfaces of the baby’s mouth, with a clean finger, cotton bud or piece of gauze, four times a day.
Gentian violetThis can be used as a SHORT-term thrush treatment to treat baby’s mouth, and diaper area by painting it on with cotton swabs. Overuse can cause painful mouth ulcers. Care must be taken when using as gentian violet is very messy and it causes dark purple stains on skin and clothing.
Nystatin Some doctors prescribe Nystatin suspension or drops. Nystatin may take longer to clear symptoms. It should be applied from a spoon as with the gel rather than the dropper so the baby doesn’t swallow it too quickly for it to work.
Home Care and Remedies Home remedies are sometimes helpful in ADDITION to traditional medicine thrush treatment.
Boil all pacifiers and artificial nipples for 20 minutes each day.
Boil all pump parts that come in contact with milk.
Wash dishes in very hot water.
Teething toys should be washed in hot, soapy water and disinfect toothbrushes and mouth appliances regularly with a bleach and water solution, or put them in the dishwasher.
Use separate towels for each member of the family.
Wash all bras, bra pads, nightgowns, and anything that comes in contact with your nipples in HOT water and fully dry on a high dryer setting or in the sun.
Avoid fermented foods such as cheese, beer and wine and lower yeast, sugar and wheat, intake in your diet.
Dietary additions such as vitamin C, zinc and B complex vitamins, garlic and yogurt with live cultures are helpful for many women who suffer from frequent thrush infections.
Some women find that rinsing nipples with 1 tablespoon vinegar to 1 cup water after every feeding is helpful. Use a fresh cotton swab for each application and mix a new solution every day.
Always wash hands with soap and water after changing your baby’s diaper. Use regular hand soap instead of antibacterial soap because it kills beneficial bacteria that control yeast growth.
Your baby can develop a yeast rash. Yeast infections can be passed in the laundry so special care must be taken when washing cloth diapers.
Throw away solid deodorants used during a thrush infection.
Thrush shouldn't affect your ability to breastfeed your baby, and you can continue during the course of your treatment.
Other causes of nipple pain to review before starting thrush treatment.