About breast and nipple thrush
|
Thrush is a fungal infection caused by the organism Candida albicans which can occur in the nipples and/or breast tissue (as well as other places in the body). It may cause significant nipple and breast pain. This pain may be severe enough to lead to early weaning if the condition is not appropriately treated.
|
If you are experiencing nipple pain which is not resolved by improved attachment, you should seek the advice of a lactation consultant or other health care professional.
|
Early diagnosis and treatment of nipple and breast thrush will help you to enjoy your breastfeeding experience.
|
Causes
|
You may have a history of vaginal thrush, recent antibiotic use and/or nipple damage.
|
Symptoms
|
- The most common symptom is nipple pain and/or breast pain.
|
- Nipple thrush pain is often described as burning, itching, or stinging and may be mild to severe. The pain is usually ongoing and is not resolved with improved positioning and attachment of your baby to the breast. Your nipples may be tender to touch and even light clothing can cause pain.
|
- Breast thrush pain can vary. It has been described as a stabbing or shooting pain, a deep ache or a burning sensation that radiates through the breast. It may be present in one or both breasts.
|
- It is characteristic for this pain to be experienced both immediately after and between feeds.
|
|
Signs
|
There are usually no obvious signs of thrush on your nipples. However some signs may be present and include:
|
- the nipple/s may appear bright pink; the areola may be reddened, dry or flaky. Rarely a fine white rash may be seen
|
- nipple damage (e.g. a crack), which is slow to heal
|
- signs of thrush may be present in your baby's mouth and/or on your baby's bottom. Thrush in the mouth appears as a thick white coating on the tongue and/or white spots on the inside of the cheeks. Thrush on the baby's bottom appears as a bright red rash with spots around it which does not clear without anti-fungal treatment.
|
|
Once the diagnosis of thrush in either you or your baby is confirmed by your lactation consultant or other health professional, it is essential that both you and your baby be treated.
|
Management and treatment
|
- Apply/take antifungal medication as directed
|
In May 2006, Janssen-Cilag (the manufacturers of miconazole oral gel) issued an alert advising pharmacists not to supply miconozole oral gel for use in infants less than six months of age. This alert is about the way that the gel is given to the baby rather than a concern about the medication itself.
|
- It is important to apply miconazole oral gel correctly:
|
 | - use the spoon supplied to measure a ¼ teaspoon dose. The spoon is NOT to be used for administering the gel
| - using a clean finger, apply small amounts of gel at a time to the inside of your baby's cheeks and over the tongue
| - apply the gel four times a day after feeds for one week then once a day for a further one to two weeks
| - if you are unsure about using the gel or you are unable to purchase the product from your pharmacy, you could try another pharmacy or you could use nilstat oral drops. However, it should be noted that the drops are not as effective for oral thrush in infants as miconazole oral gel. If using nilstat oral drops, apply 1ml to your baby's mouth four times a day for one week and then once a day for a further one to two weeks.
|
|
|
- Treat any other site of fungal infection in the whole family, i.e. vagina, nappy rash, feet.
|
- Keep your nipples dry by frequently changing breast pads as thrush thrives in a moist and warm environment
|
- Once or twice a day rinse your nipples with a solution of sodium bicarbonate 1 teaspoon diluted in 1 cup of water
|
- Clean teats and dummies thoroughly after use and boil for 5 minutes. Replace weekly if possible
|
- To prevent the spread of thrush wash your hands thoroughly after nappy changes and before and after applying any creams/lotions
|
- Wash towels, bras, cloth nursing pads etc in hot soapy water and air dry outside.
|
|
Dietary recommendations
|
It is important to maintain a healthy, well balanced diet.
|
Try to completely avoid or reduce the following foods:
|
|
|
|
- cantaloupe (rockmelon) and grapes
|
|
|
|
Add Lactobacillus acidophilus to your diet: Take the maximum recommended dose of capsules or powder available from health food stores and pharmacies.
|
Where to get further information
|
Breastfeeding Service
|
Royal Women's Hospital
Level 4
Cnr Grattan St & Flemington Rd
Parkville VIC 3052
|
Tel: (03) 8345 2400
|
Women's Health Information Centre (WHIC)
|
Royal Women's Hospital
Ground floor, front foyer
Cnr Grattan St & Flemington Rd
Parkville VIC 3052
|
Tel: (03) 8345 3045
1800 442 007 (rural callers)
|
Other contacts
|
Australian Breastfeeding Association
|
Tel: 1800 mum 2 mum (1800 686 2 686) Breastfeeding Helpline
|
Web: http://www.breastfeeding.asn.au
|
Maternal & Child Health helpline (24 hours)
|
Tel: 13 22 29
|
Disclaimer
|
The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.
|
Last updated Jan 2008
|
