Breastfeeding is natural, beautiful, amazing — and really flipping hard sometimes, especially when you are still getting the hang of it. You may have been warned about latching issues, clogged ducts, and producing enough milk, but you never expected that it would also just plain hurt. Between sore nipples and a baby who has an urge to clamp down with gusto, breastfeeding can be challenging. But how do you know the difference between normal pain and something like thrush, a yeast infection of the nipples? What does thrush feel like and how would you recognize it?
"Usually, the nipples burn, itch, and have redness on them," Dr. Yvonne Bohn, an OB-GYN at Providence Saint John’s Health Center in Santa Monica, California, tells Romper in an email interview. When it comes to thrush, she notes that "the skin may be cracked as well." According to La Leche League International, "persistent nipple pain in the early weeks of breastfeeding, or nipple pain that appears after several weeks or months of pain-free nursing, may be caused by thrush." Symptoms can include itchy, cracked, or burning nipples, and intense breast pain that is not improved with better latch-on and positioning. Oral thrush may also be accompanied by a vaginal yeast infection.
Leigh Anne O'Connor, an International Board Certified Lactation Consultant (IBCLC), tells Romper that while the occurrence of thrush is actually quite rare, you may also notice symptoms of thrush in your baby, including a white coating on their tongue that does not slough off and/or a diaper rash.
"A parent may notice thick white or cream patches on the roof of their baby's mouth, on the gums, inside the cheeks, or on the tongue," Texas-based Dr. Eboni Hollier, who is board-certified in both general and developmental and behavioral pediatrics, tells Romper in an email interview. "These patches are not easily scraped off like milk and may bleed when scraped off."
Hollier says it's unclear if thrush can be prevented in a baby, but there are several things moms can do to help lessen the risk. "It is important that parents always wash their hands after changing the baby's diaper to help prevent thrush, because it can be passed through his digestive system," she says. "It is often recommended that objects that frequently come into contact with baby's mouth, such as pacifiers and toys, be sterilized in boiling water or discarded to help prevent infections or reinfections. Also, it is recommended that bottles and other feeding equipment be frequently sterilized in order to prevent thrush."
If thrush is affecting your nipples, then O'Connor says treatment can include prescription antifungal, over-the-counter antifungal, and probiotics. "Some families will use gentian violet, but it has to be applied carefully and in the right formula." Risk factors for thrush include nipples that are already cracked or if you are taking oral contraceptives or steroids, according to Healthline.
Be sure to also make sure you receive a proper diagnosis, O'Connor says. Often women think they have thrush when they may actually be experiencing vasospasms due to a poor latch or a bacterial infection.
Other reasons for sore nipples when breastfeeding include tongue or lip ties in the baby, and the roller coaster hormones you will experience in the postpartum period. Because there are a number of things that can cause nipple pain while you are breastfeeding, it's important to consult your healthcare provider and even enlist the help of a lactation consultant.
Be sure to also keep in mind that everyday breast pain can often be treated at home with warm compresses, ice, aloe vera, saline, homemade nipple cream, and even cabbage. You know, because why wouldn't it?
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