NIPPLE / INFANT ORAL THRUSH LINK TO NIPPLE /BREAST PAIN
INTRODUCTION: Yeast infections which affect the babies’ mouths and mothers’ breast can threaten the continuation of
breastfeeding because of the extreme pain that may occur. One problem is that yeast infections of the nipple and breast
may be difficult to diagnose. A second problem is that either the mother or the baby may not appear to be infected, but may
be colonized with yeast so that re-infection occurs. Thirdly, there is little information in the medical literature about yeast
infections causing breast and nipple pain.
APPEARANCE OF YEAST: Yeast on the mucous membranes of the mouth and vagina is white. Yeast skin rashes of the
diaper area, under arms, under breasts, and in the groin appear as red patches on light colored skin. On dark skin, the
patches are a darker color. Infected nipple skin may not look different from normal healthy nipple skin.
PREDISPOSING FACTORS: Studies have found nipple damage, postpartum antibody therapy, and yeast vaginitis to be
predisposing factors. As pregnancy progresses the incidence of vaginal yeast infections increases. The infant can acquire a
yeast infection from his or her mother at birth, so treatment of vaginitis during pregnancy is important.
DETECTING NIPPLE AND BREAST CANDIDIASIS: The unbelievable pain that comes with a yeast infection of the
nipples or in the breast can lead to premature weaning, so early detection and treatment are needed. Most women use the
work “burning” as they describe their pain. One mother described her pain as follows: “My nipple feels as if it has a piece
of broken glass in it.” Some mothers report shooting, “nerve pain”, burning pains in the breasts and/or nipples during
and/or after feedings. Some experience pain that runs down the arm or across the back in addition to breast pain. There is
NO GOOD WAY TO TEST for yeast on the nipple, because it rarely cultures. There is no test that shows whether the
normal skin colonization of yeast has changed to an invasive infection of yeast. Since there is little to see on the nipples
and the baby and /or mother may be asymptomatic, it is appropriate to treat the mother and baby based on the woman’s
description of her pain. The excruciating pain must be resolved quickly, so that breastfeeding will continue.
TREATMENT: (SEE BACK SIDE) Treatment for both mother and baby MUST occur at the same time, EVEN if only
one has symptoms. The baby’s health care practitioner can prescribe treatment for the infant. If the nipple is damaged
there can also be a bacterial infection along with a yeast infection. Other women may have an inflammation.
Simultaneous treatment of the nipples with a topical antibacterial cream or ointment or a steroid cream may help. If the
baby sucks on his or her fingers or thumbs, they should be treated. Other places any family member has a yeast infection
should be treated, such as diaper rash, vaginal yeast infection, finger and toe nail fungus, jock itch, etc. Moisture left
behind by some baby wipes and corn starch, an ingredient in some baby powders, promote the growth of yeast.
SPREAD OF YEAST: Because family members are in close contact, it is easy to spread yeast.
Ways to cut down on the spread and or re-infection of:
 GOOD HANDWASHING is important. Wash with warm soapy water and use lots of friction for at least 15 seconds.
 Use PAPER TOWELS for hand drying then discard, since yeast can live on a moist towel.
 Use BATH TOWEL only ONCE the wash it.
 TOWELS AND CLOTHING that come in contact with the yeast should be washed in very hot water (above 50
Centigrade or 122 Fahrenheit). Hang wash in the sun to dry, if possible. Ironing will help kill yeast.
 CLEAN BRA every day or more often. The use of disposable pads may be more beneficial over cotton ones.
 A BLEACH SOLUTION of ¾ cup household bleach to one gallon of water (or 2 tablespoons to 2 2/3 cups of water)
can be used to disinfect surfaces such as a diaper changing pad, baby furniture, and toys. Wipe with the bleach
solution, rinse, and air dry.
 BOIL items used in the baby’s mouth (pacifiers, bottle nipples, teething toys) and anything that comes in contact
with the breastmilk (pump kit parts, cloth breast pads, and may be even the bra) for 20 minutes once a day.
 After one-week DISCARD all bottle nipples and pacifiers and purchase new ones.
 FREEZING may or may not KILL YEAST (it depends on the source you research unfortunately), so feed the baby any
milk collected during the yeast infection within 24 hour of pumping. Any milk already frozen may be fine when
thawed and used after recovery or it may increase exposure and re-infection. The BEST DEFENSE is a healthy
environment and immune system!
 REINFECTION SOURCES: Think of places yeast can hide. Check pets and farm animal for yeast, especially their
ears. Get new toothbrushes for the whole family. Check dental appliances.
 If a yeast infection is NOT CLEARING, the mother can try reducing sugar and dairy products in her diet. Some
women report that adding the following to their diet helps: acidophilus, garlic, zinc, and B vitamins (from a source
other than nutritional yeast). A healthy body is the best defense against an overgrowth of yeast
 Mother Love THRUSH RELIEF SALVE (an excellent all-natural salve) placed on nipples after feeds is effective on
thrush infected nipples. It works wonderful for diaper rash, including persistent, inflamed diaper rash possibly caused
by yeast. (You can purchase this at the offices of The Women’s Healthcare Group)
Hoover, Kay: The Link Between Infants’ Oral Thrush and Nipple/Breast Pain in Lactating Women, Morton, PA: Article, 1996