Our bodies are made up of many types of bacteria and yeast. Candida albicans is one of 80 different fungi living on the surface of our bodies.(1) Our skin, mucus membranes and gut all have yeast, viruses and bacteria. C. albicans is the most abundant of the fungi in our body, living mostly in warm, moist areas including the mouth, genitals and the gut.
In balance with other bacteria and yeast, C. albicans causes no symptoms. A disruption to the balance of our good and bad bacteria can allow an overgrowth of C. albicans and the result is an uncomfortable yeast infection.
What increases the risk of getting thrush?
- Weakened immune system - people who have diabetes or anemia are more susceptible to yeast overgrowth.
- Stress - Cortisol is a hormone produced to deal with elevated stress. It lowers the amount of progesterone that is made and estrogen levels increase. Excess estrogen can feed yeast production.
- Vaginal yeast infection - if a mom has a yeast infection close to or during delivery of her baby, yeast symptoms may be seen in other areas of the body like the breasts. Yeast is naturally passed to the baby during the birth process. This may be a likely time your baby is susceptible to oral thrush.
- Antibiotics - given to either the mother or baby, kill the good and bad bacteria present. Without the good bacteria there to keep C. albicans in check, it can multiply and turn into a yeast infection.
- Cracked or damaged nipples - the broken down skin lets yeast and bacteria enter.
- Birth control pills - hormonal birth control, like the pill, with estrogen can increase the risk of yeast infections.
- Diet - the foods we eat contribute to the health of our gut. Eating foods that we are sensitive to can break down the lining of the gut leading to leaky gut. Not having enough good bacteria or when that bacteria is harmed, yeast can take over and travel to other areas of the body causing a yeast infection. A diet high in sugar or processed foods can make it worse because sugar is food for yeast and we don’t want to feed it, we want to starve it so it can not overgrow.
- History of vaginal yeast infections.
Symptoms of thrush in babies
- Foul smelling poop
- Mucus in poop
- White patches in the mouth on the inside of the cheeks, roof of the mouth and tongue
- Red, bumpy, irritated looking diaper rash sometimes with a raised ring around the anus
- Excessive gassiness
- Fussy during nursing and may go on and off during a feeding because their mouth or throat is sore
- Refusing to nurse
- Shiny or pearly white appearance of spots of the inside of the lips
- May have no symptoms at all
Symptoms of yeast in the mom
- Shiny appearance of the areola
- Flaky skin on the areola
- Skin on the areola may look puffy
- Stinging, burning pain during and after feeding often described as feeling like being stabbed with shards of glass
- Nipples are sensitive to any touch, even very light touch or water in the shower hitting the nipples
- Nipples may appear bright pink
- May have no symptoms at all
When it might not be thrush
Some conditions have similar symptoms of a yeast infection and are misdiagnosed as thrush.
- Tongue tie or high palate - the tongue is meant to rest on the roof of the mouth during times of rest and in between feeding. Friction from the tongue resting on the roof of the mouth helps clean the tongue, gently scrubbing normal milk residue off the tongue. When there is restriction from ties preventing the tongue to have full range of motion, the tongue stays low in the mouth often resting on the floor of the mouth and the white residue builds. Over time, it can appear to be thick and the tongue coated in white patches that can be misdiagnosed as thrush. Milk on the tongue will easily wipe away, but yeast on your baby’s tongue will not go away when you try to scrape it off if thrush is the cause. Mothers can also mistake the pain they feel that sometimes accompanies breastfeeding a tongue tied baby for a ductal yeast infection.
- Vasospasm - constriction of the blood vessels when the baby is latching more shallow than deep can cause shooting pain for the mom. The pain from vasospasms usually goes away in between feeding versus the pain or itching from thrush which persists in between feeding. There may be discoloration of the nipple tip turning white or compression visible on the nipple, like a crease across the nipple or lipstick shape when pain is caused by a compromised latch leading to vasospasms which is not the case with yeast. The nipple often looks more bright pink when yeast is to blame.
Treating thrush & yeast infections
- Use a clean cotton washcloth or cotton swab dipped in a mixture of 1 teaspoon of baking soda and 1 cup of water and wipe inside the baby’s mouth. Repeat after every feeding.
- Use calendula and coconut oil on diaper rash and allow time for your baby to be diaper free.
- Homeopathic Borax is used to get rid of oral thrush in babies.(2)
- Change breast pads often - yeast likes to grow in warm, dark & moist environments. Go topless if possible for part of the day to inhibit yeast growth.
- A baking soda wash, calendula hydrosol, colloidal silver and coconut oil applied to your nipples can help reduce yeast. Some people find vinegar and water wash helpful, but it can also damage sensitive skin. No need to wipe coconut oil off before nursing again, only wipe off any excess. Coconut oil is a source of lauric acid which is converted to monolaurin in the body and has been shown to be antifungal and helpful in treating candida.(3)
- Lactobacillus acidophilus probiotics can help treat a yeast infection as well as prevent reoccurrence. They feed the good bacteria you want to thrive and multiply to keep yeast in balance. Lactobacillus competes with C. albicans for glucose. Without glucose, yeast can not survive.(6) Lactobacillus fermentum is another strain found in the mouth, GI tract and vaginal tract. It has been shown to help support vaginal health reducing yeast infections and UTIs in women.(9)
Preventing yeast from reoccurring
- Wash bottles, nipples, pacifiers and pump parts with hot soapy water and allow to air dry after every pumping session and feeding.
- Boost your immune system - supplement with Vitamin C, Vitamin A, Vitamin D and zinc
- Make dietary changes cutting out sugary foods and drinks and foods high in carbohydrate or starch because the body recognizes them as sugar. Eat high fiber, whole foods. These foods feed the good bacteria in your gut allowing them to multiply and keep the yeast from taking over.
- Yeast robs the body of some vitamins and minerals including many B vitamins. Biotin metabolizes fats and carbohydrates. It is essential for healthy skin, hair and nails.
- Herbs - many herbs in lactation supplements taken to boost milk production also support your body to keep overgrowth of yeast and even reduce symptoms during yeast infections. Moringa, nettles and black cumin seed are among the herbs that can help reduce severity of symptoms during yeast infections.
Treatment of thrush with medications like diflucan, nystatin and fluconazole do not work for everyone. They can deplete nutrients in the body and cause side effects. Unless you address the root cause of yeast overgrowth, it is likely to return and taking antifungal medications may not work effectively.(5)
Topical steroid or creams containing steroids like APNO (all purpose nipple ointment) is a common recommendation for treating yeast. Steroids deplete Vitamin C, calcium, vitamin D, chromium, magnesium, zinc, folate, potassium and vitamin A. Steroids suppress and weaken the immune system rather than boost it. They can be addictive and hard to discontinue.(4)
In the past, gentian violet was recommended to treat thrush. It is carcinogenic, derived from coal tar and not safe to use topically or in the mouth.(8) It can cause damage to mucous membranes and cause ulcers in the mouth and throat.
It is possible for only you or your baby to show signs of having candida. Although yeast can spread, it doesn't spread easily to other family members.
It is safe to feed your baby pumped milk while you have candida. It is best to feed that milk during the time you are treating a yeast infection. If you have already pumped and stored milk during a time you had thrush, you can consider heating it to kill the yeast. Yeast does not grow while it is in the freezer, but freezing does not kill yeast.(7)