As a Certified Breastfeeding Counselor (CBC), you support clients through a variety of breastfeeding challenges. While breastfeeding can be beautiful, and is a natural process, it can come with difficulties. Thrush and breastfeeding is a common challenge which can pop up through the breastfeeding journey.

As a CBC, you do not diagnose or treat things such as thrush. However, it is important to be aware with what it is, how it is treated, and how to educate families about it. Thrush is somewhat common and is caused by an overgrowth of candida albicans.

What is Thrush?

Thrush, also known as oral candidiasis, is a fungal infection caused by candida albicans. It commonly appears as white patches in the mouth, on the tongue, and on the inner cheeks. When thrush affects the lactating parent, it can also lead to symptoms such as burning pain in the nipples and breasts.

In Infants, oral thrush can also lead to a difficult to clear diaper rash. This is because the rash is yeast, rather than common skin irritation. Babies can have just oral thrush and just diaper rash thrush, but they can also have both at the same time.

Thrush and Breastfeeding – Symptoms of Thrush in Lactating Parents

Thrush can impact each person differently. And remember, as a CBC you are not diagnosing parents or babies. However, you can educate parents about symptoms of thrush they might feel and instruct them to reach out to their healthcare provider.

Symptoms of Thrush in Lactating Parents:

1. Nipple pain or discomfort, especially during or after feeding.
2. Nipple redness or inflammation.
3. Shiny or flaky skin on the nipple or areola.
4. Shooting pain in the breast during or after feeding.
5. Itchy or burning sensation on the nipples.

Symptoms can vary person to person. In some cases, there is only mild irritation. However, in other cases, the symptoms can be quite painful, especially the shooting pain sensation. In those cases, parents might wonder if they have a bacterial infection like mastitis or a clogged duct.

As a CBC, you do not need to decipher between different causes. Your role is to simply provide information about common symptoms and encourage them to contact a healthcare provider for an accurate diagnosis and treatment plan.

Thrush and Breastfeeding – Symptoms of Thrush in Babies

For babies, thrush and breastfeeding can be a bit of a challenge. Babies cannot articulate what exactly is causing their discomfort. Fortunately, there are often visible signs of thrush. This is one reason providers often check inside baby’s mouth during regular well checks. Small signs of thrush are sometimes caught before worsening or spreading to the lactating parent.

Symptoms of Thrush in Breastfed Babies:

1. White patches in the baby’s mouth, tongue, or inner cheeks (which cannot be wiped away easily).
2. Fussiness or irritability during feeding.
3. Refusal to latch or feed.
4. Diaper rash with a persistent redness and raised bumps.
5. Gassiness or colic-like symptoms.

Often, persistent diaper rash and oral patches of thrush are the easiest symptoms to see. If a parent notices that alongside nipple pain, it is very important both are treated. In some cases, persistent thrush occurs because each party continues to reinfect each other.

Can Thrush Be Prevented?

There are things which might reduce the risk of thrush. However, there are circumstances which can make a baby or parent more likely to have thrush. Some of these things are out of our control, such as a premature baby or an otherwise immunocompromised infant.

Persistent thrush or reoccurring thrush is often more likely when either baby or parent is immunocompromised. Baby’s oral structure can also increase their risk of thrush as friction during feeds and pacifier use can increase the risk of thrush.

That said, there are still things which can reduce the risk of thrush in some.

Prevention Tips:

1. Maintain Good Hygiene: Wash your hands frequently, especially before breastfeeding or handling your baby’s mouth.
2. Proper Breastfeeding Technique: Ensure correct latch and positioning to prevent nipple damage that could make you more susceptible to thrush.
3. Limit Sugar Intake: Candida thrives on sugar, so reducing your sugar intake can help prevent thrush.
4. Air Dry Nipples: After breastfeeding, allow your nipples to air dry before putting on a bra or clothing.
5. Clean Nursing Bras and Breast Pads: Regularly wash and dry your nursing bras and breast pads to prevent the growth of yeast.

Breastfeeding and Thrush – How Is It Treated?

As mentioned, you are not diagnosing or treating thrush. However, you can help parents learn about their options. Clients should always reach out to their provider before using any products.

Treatment Options:

1. Antifungal Medications: Their healthcare provider may prescribe antifungal medications for both you and your baby, such as oral antifungal drops or creams.
2. Probiotics: Taking probiotics can help restore the balance of good bacteria in the body and prevent the overgrowth of yeast.
3. Gentian Violet: In some cases, gentian violet, an antifungal dye, may be recommended for treating thrush in breastfeeding mothers and babies. However, in recent years this product has fallen out of favor.
4. Nystatin Cream: This antifungal cream can be applied to the baby’s mouth and the mother’s nipples to treat thrush.
5. Boil or Sterilize Pacifiers and Breast Pump Parts: If you use pacifiers or breast pumps, ensure they are thoroughly cleaned and sterilized to prevent reinfection.

Thrush while breastfeeding can be uncomfortable and challenging, but with proper prevention and treatment, one can overcome it and continue to breastfeed.