Treating Yeast While Breastfeeding

Yeast (also called thrush or Candida) is a fungus that grows in warm, dark, moist environments, like the linings of the mouth and vagina, the diaper area, skin folds, bra padding, and on nipples that are frequently wet.

Yeast is frequently over-diagnosed, and most nipple pain is not due to a yeast infection. It is very important to have a full lactation evaluation before considering treatment for a yeast infection.

You may have breast yeast if you have:

• Constant nipple pain in the early weeks of breastfeeding.
• Nipple pain that starts after breastfeeding is going well and hasn’t been painful.
• Itchy or burning nipples that look pink or red, shiny, or flaky.
• Shooting pains deep in your breast during or after you nurse or pump.
• Intense nipple or breast pain that doesn’t get better with better latch-on and positioning.
• You are taking, or have just finished taking, antibiotics.
• You have a vaginal yeast infection.
• You’ve been told your baby has oral thrush (thick, white patches in his/her mouth) and/or a yeasty diaper rash.

Nipples with any sort of rash should be seen right away by your doctor. It could be a sign of another problem that needs treatment. Your doctor may take a swab of your nipple area and send it to a lab for testing.

Medical Treatment

For Baby

• If you’re told your baby has yeast they will be treated with either a liquid medicine in their mouth called Nystatin (if yeast is found in their mouth) or an anti-fungal skin cream (if yeast is found on their skin).

For You

• If the yeast infection is only on your nipples, then you can use a  prescribed anti-fungal skin cream. Check with your doctor for instructions.
• If the yeast infection is causing shooting or stabbing pains deep in your breast, an oral medicine might be prescribed.
• Treatment should last at least a few days after you (and your baby) feel all better to make sure it is gone.

What Can I Do?

After a diagnosis of yeast, some people recommend carefully washing what has come in contact with the infection, like breast pads and bottle nipples.

Hygiene

• Change or wash anything that comes in direct contact with your nipples (bras, bra pads, towels, etc.) in hot water with bleach daily. Dry on hot setting in the dryer.
• Use disposable breast pads until you are done using all medicines.
• Wash any pump parts that come in contact with the skin or milk in warm soapy water after each use. You can:
  • Boil the parts for 20 minutes
  • Wash the parts in the dishwasher on high heat setting, or
  • Sterilize the parts using microwave steam bags.

Diet

There is limited evidence that a change in diet prevents yeast from coming back. Probiotics may help to restore your body’s normal microbiome (“good bacteria”) after antibiotic use.

• Add some "good" bacteria to your diet with yogurt or supplements called probiotics that contain lactobacillus acidophilus.
• Limit the amount of sugar in your diet. This means cutting down on sugary foods and refined carbohydrates.

Can I Feed the Baby this Milk? 

Yes: While you are using medicines for yeast your fresh, refrigerated, or frozen pumped breast milk can be used safely for your baby.

Freezing temporarily "shuts off" the yeast, but does not kill it. Be sure to label all milk that you’ve pumped during if you or your baby has thrush/yeast. Your baby’s doctor will decide if it is safe to use.

For questions or more information, your doctor or your baby’s doctor can call the Lactation Study Center (585) 275-0088.

For outpatient help, call UR Medicine Breastfeeding & Lactation Services at (585) 276-MILK.