breastfeeding, chestfeeding, Diabetes, mastitis, Nipple concerns

Is it thrush?

“Nipple thrush pain is often described as burning, itching, or stinging and may be mild to severe. The pain is usually ongoing and doesn’t go away with improved positioning and attachment of your baby to the breast.”

“When you have nipple thrush, your nipple appearance may change to being shiny in appearance, sometimes chapped, blistered with white patches but may also look completely normal. You may also experience itchy, flaky and red nipples or areola.”

Picture of oral thrush in an infant

Thrush is an overgrowth of candida or yeast. It mostly commonly causes an infection and overgrowth in people who are immunocompromised.  It can overgrow in areas with skin folds which are moist and warm, like armpits, the vagina, etc.  It’s very rare to have yeast/candida/thrush in highly vascularized areas like the breasts and nipples.

Research has shown that in cases of suspected thrush the parent is most likely experiencing mastitis 
“microbiological analysis of milk samples provided by 529 women with symptoms compatible with “mammary candidiasis”. Nipple swabs and nipple biopsy samples were also collected… Results showed that the role played by yeasts in breast and nipple pain is, if any, marginal…our results strongly support that coagulase-negative staphylococci and streptococci are the agents responsible for such cases.

When providers visually assess for thrush, they may be seeing dermatitis rather than a yeast overgrowth on the nipples.  Dermatitis is an allergic reaction or irritation caused by something the parent is sensitive to on their skin.  This can include creams, ointments, and medications.

Here are some pictures of parents who thought they had thrush but actually had dermatitis!

Below, is what yeast on the skin actually looks like

So what you should you do if you think you have thrush?

Talk to your Lactation Consultant for a full feeding and breast evaluation. They can make referrals to providers for treatment, if needed, and can help figure out what’s actually going on!

❤ Megan

breastfeeding, chestfeeding, mastitis

Mastitis, ouch!

Mastitis is an inflammation in your breasts which may become an infection if not addressed.  It affects about 1/3 of lactating parents but can be prevented and treated with quick resolution.


Mastitis is caused by inflammation and can be worsened by massage, excessive heat, overfeeding/overpumping. 
If you’ve recently had a dose of antibiotics, your risk of developing mastitis is higher because a healthy balance of microbes throughout our body reduces inflammation and bacterial overgrowth. If left untreated, it can develop into an infection which will cause fever, fatigue, and overall body aches.

Mastitis may feel like a burning or hot sensation in your breast.  It might start at the nipple and go deep into the breast.  It’s more frequently felt in the lower parts of the breast. You may notice plugging or red areas in the breast.  Early inflammation is sometimes mistaken for engorgement or plugged ducts.

For some parents, the feeling happens during milk ejection (letdown) and can feel like a burning or stinging sensation starting at the nipple and moving deeper into the breast.

Most commonly mastitis occurs during the first 2-4 weeks.  Your risk of developing mastitis is higher if you have diabetes or if you have had antibiotics during or after delivery (ie, Group B Strep).  It’s especially important to feed baby often and well in these situations.

Your milk is safe for baby when you have mastitis

Your Lactation Consultant can help you figure out how to
prevent mastitis from re-occurring.

Self-care can resolve the inflammation in most cases without the use of medication.

To treat mastitis, try the following:

  1. Warmth before feeding.  A warm shower or warm pack applied to the breast.
  2. Ibuprofen and/or Tylenol as needed along with a cool pack applied after feeding/pumping.
  3. Avoid massage and excessive pumping.
  4. 5-10 grams daily oral sunflower lecithin supplementation to reduce inflammation.
  5. High-quality probiotics containing L. salivarius, fermentum, and gasseri. are generally refrigerated and contain 10 billion CFUs or higher. Continue taking the probiotics for 2 weeks after symptoms resolve.

Older recommendations included warm compresses, feeding and pumping very often, as well as vigorous massage. We now know this can increase symptoms.

Multiple studies have reported that probiotics (beneficial bacteria) are effective in treating infectious mastitis and also resulted in a lower occurrence of repeat mastitis compared to antibiotic treatment.

Call your doctor if you experience:

Fever over 101F
Flu-like aches
Nausea and chills
Pain and swelling in the breasts
Red, hot, tender area which is often wedge shaped
Red streaking toward the armpit

You should start to feel better in 8-24 hours.  If you are not feeling better with self-care or you develop a fever, flu-like symptoms, or any signs of infection you will need to see your physician.  Most people feel much better after 2 days but it’s important to take all 10-14 days of your medication or you may develop an abscess which requires surgical treatment.  The most common antibiotics prescribed for mastitis are dicloxacillin or flucoxacillian.  

Antibiotics can cause digestive symptoms so follow your doctor’s directions and taken your probiotic dose 2-4hrs after your medication.

Work with your Lactation Consultant to prevent mastitis from happening again. 

If you get mastitis frequently or it’s always in the same area, your doctor may order an ultrasound to get more information.

❤ Megan Dunn, IBCLC