Candida (also called yeast, monilla or thrush) is a fungus that thrives in warm, dark, moist environments, such as the mucus membranes of the mouth and vagina, the diaper area, skin folds, bra pads, and on persistently wet nipples.
Suspect candida as the cause of your sore nipples if:
• Your nipples are extremely sore, burning, itching, red, or blistery.
• You experience shooting pains in your breasts during or just after feeding (especially during your milk ejection reflex).
• The usual remedies for sore nipples aren’t working.
• Baby has oral thrush (white, cottage-cheese-like patches on the tongue and sides of the mouth) and/or a yeasty diaper rash.
• Your nipples suddenly become sore after a period of pain-free breastfeeding.
• You are taking, or have just finished taking, a course of antibiotics. Yeast infections are common following antibiotic treatment.
Here are some simple suggestions that may help prevent a yeast infection on your nipples, or cure a mild case of yeast infection:
• Yeast organisms hate sunlight, so give your bra and breasts a sun bath. Expose your nipples to sunlight for several minutes several times a day. After washing them, dry your bras in the sunlight.
• Air-dry your nipples after each feeding
• Avoid plastic-lined breast pads that irritate skin and trap leaked milk.
• Change nursing pads after each feeding.
• Wear 100 percent cotton bras and wash them daily in very hot water.
• Thoroughly wash pump parts that come in contact with your breasts in a bleach solution and boil them in water for five minutes daily.
If the simple home remedies listed above don’t bring relief, consult your healthcare provider about the following treatments:
• Apply an antifungal cream (mycostatin, clotrimazole, myconazole) to your nipples as suggested or prescribed by your doctor.
• If you have a candida infection in your nipples, baby should be treated for thrush even if you can’t see any white patches in the mouth. Your healthcare provider will prescribe an oral antifungal suspension that should be painted on baby’s tongue, roof, and sides of the mouth three or four times a day for a couple of weeks.
• If baby has a candida diaper rash, treat it with an over-the-counter antifungal cream.
• Eat lots of yogurt (the kind with live active cultures) and take oral acidophilus. This encourages good bacteria to live in your gut and discourages the growth of yeast.
• If the candida is resistant to the standard treatments described above, in consultation with your healthcare provider, try a 0.25 – 0.5 percent solution of gentian violet applied to your nipples twice a day for three days. Gentian violet is effective, but messy. Also, apply a small amount once a day to baby’s mouth, but be aware that overuse of gentian violet may irritate the sensitive oral mucus membranes of baby’s mouth. Apply Vaseline to baby’s lips before using the gentian violet to avoid purple stains.
• Warning – gentian violet has been used for many years to treat thrush. A recent study done in Australia has linked gentian violet to cancer of the mouth. However, many other professionals around the world believe that it is safe, and continue to recommend it. For this reason, we suggest you use this remedy sparingly, and for as little time as possible.
• If your baby has thrush but your nipples are not yet sore, apply the prescribed medicine to baby’s mouth just before feeding so that your nipples get the preventive benefit of the medication as well.
• If your healthcare provider advises you to wash the creams off your nipples prior to breastfeeding, do so gently with warm water.
• While nursing on a candida-infected nipple can be exquisitely painful, it is necessary to keep the affected breast empty to prevent mastitis, or even a candida infection deeper into the breast tissue. Pay particular attention to proper latch-on and easing your baby off your nipples at the end of the feeding, since infected nipples are more sensitive and prone to injury from improper sucking patterns.
Yeast infections can be very persistent. Use the full course of medication suggested by your doctor, and continue using the home remedies for several weeks so that the infection will not reoccur.