How to Spot It

 Thrush is a nasty affliction that causes more problems with breastfeeding than probably anything but a poor latch.  It is characterized by burning and itching on or around the nipples, and sometimes even inside the breast (called Ductal Thrush), and the nipple usually is very pink to bright red.  The nursing woman may notice a deep shooting pain in the breast and often has pain that continues long into or throughout the entire nursing session.  She may also notice signs of yeast infection in other parts of her or baby's body (vaginal, diaper area, neck folds, etc.)  Often thrush will transfer to or from baby’s mouth, and you may be able to see signs of it there, too (but not always, no matter what your pediatrician may tell you).  Look for white patches on the gums, inner cheeks and/or tongue. 

How to Treat It

There are various treatments for thrush.  Some are effective and some aren’t.  Some are messy and can be irritating, some aren’t.  I’ve been through literally all of them, and have been witness to hundreds of women’s testimonials on bulletin boards as to what has and hasn’t worked for them.  I discuss them below.

• Nystatin – Often a doctor will prescribe liquid Nystatin for you to rub in baby’s mouth, and maybe even mention rubbing it on your nipples, after each feeding for a few days to 2 weeks.  I have never once seen this alone have any effect on thrush, personally or in others, and the treatments have always had to be accelerated.
• Diflucan - Diflucan may be enough to reverse a case of thrush, if given to both mother and baby (if both are afflicted), and if given to mother for no less than 14 days.  The problem with this treatment is that doctors are often reluctant to write such a prescription and insurance companies are even more reluctant to pay for it.  If you need information to take with you to the doctor's office to back you up, print Dr. Jack Newman's article on thrush treatments.  (Dr Jack Newman is the leading medical professional in all things breastfeeding related.) 
• Gentian Violet – The next stage of attack is usually gentian violet.  This is a brilliantly purple antiseptic/astringent used for cleaning open wounds for many years before the modern-day Neosporins and the like.  It can be very irritating to the soft tissues and mucous membranes of baby’s mouth and your nipples and it is generally recommended not to use it for more than 3 days on either of you.  Rarely is thrush wiped out in 3 days, so even gentian violet is not a very effective treatment.  Beyond this, it hopelessly stains everything it touches purple. 
• Over the Counter Anti-yeast Creams – Now we are getting somewhere.  Used in conjunction with Nystatin in baby’s mouth, Lotrimin AF on the nipples (our personal recommendation for the most effective and economical antifungal) is somewhat effective.  Applied thinly after each feeding, meaning you will see a slight shininess on the nipples, but no actual cream, it will have absorbed enough to be harmless by the time baby feeds again.  Use until symptoms disappear.
• Sunlight and Air-Drying - Thrush is a yeast overgrowth.  Yeast thrive in warm, dark, moist places.  This is why you often find overgrowths in the vulvar area, breastfeeding nipples, and babies’ mouths.  Natural enemies of thrush are sunlight and dry places.  Do your best to air dry your nipples after every feeding, whether or not you are currently experiencing a period of thrush, and try to expose thrush nipples so some sunlight for a few minutes a day.
• Vinegar Rinses - Vinegar is a natural antimicrobial and can do wonders against yeast. Choose only natural apple cider vinegar found in a health food store for the maximum effect. If it is cloudy it will most likely do the job. Don't even bother with distilled white vinegar. It has been so altered that it has none of the beneficial effects of true vinegar, and is suitable only for cleaning your home.
• Garlic and Echinacea - Both of these treatments boost your immune system, allowing your body to try to rebalance itself.  Either can be very beneficial whenever you are battling any body imbalance.
• Grapefruit Seed Extract - Grapefruit Seed Extract is a broad-spectrum antimicrobial compound extracted from the seeds and pulp of grapefruit. It is an extremely potent and effective bactericide, fungicide, antiviral and antiparasitic compound. If used diligently, it typically will clear up thrush within a couple of days. Read Dr. Jay Gordon's article here for dosing information.  (Dr Jay Gordon is a renowned attachment parent advocating pediatrician.)
• Yeast-Cleanse - There is a product produced by Solaray, found at health food stores and online, called Yeast-Cleanse. It contains the grapefruit seed extract and garlic mentioned above, along with several other very effective fungicides. I have used this product with great results, as has my entire family. Even my aunt, having contracted throat thrush during her chemotherapy treatments, found this product to work miracles for her in just 2 short days.