Category: Nipple concerns

breastfeeding, chestfeeding, Diabetes, mastitis, Nipple concerns

Is it thrush?

dunnmegand

“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, Nipple concerns

Nipple Pain

dunnmegand

Unfortunately, many parents experience nipple discomfort. 

It’s not that breastfeeding causes this pain but other things can like a latch which isn’t deep enough, infant conditions like tongue tie, pumping (too much, wrong size flange…), or even some ointments and balms.

The best nipple ointments for soothing the skin or for use as a pumping lubricant don’t contain lanolin, coconut oil, or petroleum products. 
Try an organic product like Earth Mama, Bamboobies, or Motherlove. 
Other ingredients may cause an allergic reaction or irritation (dermatitis).

There is a prescription ointment called APNO (All Purpose Nipple Ointment) which should be used only as indicated as it’s an anti-bacterial, anti-fungal, and steroidal compound.  Nipple pain is very rarely caused by fungus/yeast but anti-fungal medications can actually increase pain.

Care for the nipple like any other skin on your body… Wash once per day with mild, scent free soap. Keep the skin clean and dry.

If there is tissue damage:
Lubricate with a moisturizing balm (see above) or try Medi-honey (irradiated, medical grade honey and many nipple wounds respond well to treatment).

Hydrogel pads (changed daily) protect the wound from irritation and keeps the site clean.  You can use this with your nipple balm.  Expect healing to take at least 1 week.

Avoid:

  • Nipple shields. Despite the name, these products do not shield your nipple and can cause irritation.  They also increase risk of low supply, engorgement, and mastitis.
  • Gentian violet can cause tissue ulceration.  It’s often used to combat yeast which is very unlikely to infect the nipple.
  • Epsom salt soaks, tea bags, or excessive use of moist compress can break down skin.
  • Breast shells can cause swelling in the areola and often increase pain.
  • Using a hair dryer which will dry out the skin.

Nipple bleb.  A bleb can look like a little blister which may be white or yellow on the nipple.  Blebs show up when there is deeper inflammation and bacterial imbalance. Treat the underlying mastitis (inflammation) and the bleb will resolve. If you have a bleb, let your Lactation Consultant know.  Do not try to squeeze or pop the bleb as that will open the skin for infection.


Vasospasm. If your nipples turn colors after feeding (white, purple, or blue) you may be experiencing vasospasm.  This is caused by a constriction of blood flow from nipple damage, poor latch, or topical anti-fungals. Fixing the cause stops the vasospasm.

As always, check with your Lactation Consultant for further guidance.