Microsoft word - 037 prha breastfeeding and yeast parent handout may 2011.doc

Yeast normally lives in our bodies without causing a problem. It lives in moist, warm and dark places such as the mouth, nipple, vagina and groin. Yeast can spread easily from one person to another. Sometimes it overgrows and causes a yeast infection in the mother and/or her baby. WHO IS LIKELY TO GET A YEAST INFECTION?
•A MOTHER with sore cracked nipples, a history of vaginal yeast infections, antibiotic use during or since delivery and/or a baby with thrush (yeast) in his mouth. •A BABY who is/has been on antibiotics or has a mother with the yeast infection (vaginal or breast). HOW TO KNOW IF YOU HAVE A YEAST INFECTION
sore nipples after a time of pain free nursing burning or shooting nipple and breast pain during and/or after nursing nipples that are very sensitive to touch (of clothing, shower etc) itchy nipples or flaking skin on nipples crescent-shaped cracks at base of nipple nipples that blanche (turn white) after feeding sore or cracked nipples that do not heal despite a healthy thriving baby with good latch white spots on his tongue or cheeks (thrush) changes in his behavior - fussy during feeding or refusing to feed pulling off the breast or "clicking" while feeding or your baby can have no symptoms at all TREATMENT CHOICES / OPTIONS
Breastfeeding can and should continue during treatment! It is important to treat both you and your baby, even if only one of you has signs of a yeast infection. Treatment of you and your baby should continue until you are both symptom-free for at least 1 week. Every mother and baby is different – these are suggestions for treatment only. Treatment for mother: Anti-yeast ointments: • If you are not having nipple pain, or your pain is mild, Nystatin, Canestan (Clotrimazole) or Monistat (Miconazole) can be used on your nipples; these ointments can be purchased without a prescription. If your nipples are cracked and sore, “All Purpose Nipple Ointment” or Viaderm KC Ointment are more effective. These require a prescription. A small amount of ointment should be applied to your nipples and areola after every breastfeeding. These ointments are safe for your baby and do not need to be washed off before breastfeeding. Gentian Violet (1%) solution can also be painted on your nipples once a day for 4 to 7 days. This can be used as initial treatment for severe pain or it can be used in addition to the above ointments if pain continues or worsens. If your baby does not have thrush, use this solution after feeding (less messy). If you develop severe breast pain that is not getting better, you may need oral treatment (Diflucan or Ketoconazole). This should be used in addition to nipple and infant treatments. Treatment for baby If you baby has mild or no symptoms: • Nystatin oral suspension can be applied to your baby's mouth after every breastfeeding. This liquid may decrease the growth of yeast between feedings, even if your baby has no symptoms. To apply, pour 1/2 dropper into a small cup. Dip a Q-tip into this liquid and paint the inside of your baby's mouth (inside cheeks, under tongue, around gum line). Any leftover medicine can be swallowed by your baby. Note: Babies who are not breastfeeding receive “1 dropper 4 times a day”. Because yeast grows very fast and spreads to mothers quickly, using ½ dropper after every feeding works best for breastfeeding babies. If your baby has moderate to severe symptoms and/or these symptoms are not getting better: • Gentian Violet (.5 or 1%) can also be applied once a day for 4 to 7 days. This can also be used as initial treatment or can be used in addition to the above for extra treatment if necessary To apply, dip a Q-tip in the Gentian Violet and quickly paint the inside of your baby's mouth to cover his cheeks and tongue or paint your nipples and then breastfeed - this way both you and your baby are treated. Gentian Violet may cause mouth “ulcers”. Therefore, check your baby’s mouth daily. Gentian Violet should be used in addition to the treatments already listed. OTHER SUGGESTIONS TO TREAT A YEAST INFECTION

Natural treatments that may help to limit the yeast in your body:

Grapefruit Seed Extract capsules: 250 mg 3 times a day (may interfere with other prescription drugs) Grapefruit Seed Extract liquid: swab your baby’s mouth and your nipples with 5-10 drops of grapefruit seed extract liquid in 1 ounce of water; apply after each feeding for 3-4 days Limit sweet foods and yeast containing foods (breads) in your diets Eat yogurt containing active bacterial culture several times a day Rinse your nipples after feeding with an acidic solution of 1Tbsp of vinegar in 1 cup of water Good handwashing for entire family with non anti-bacterial soap Consider using paper towels to prevent spreading yeast Daily boiling of any items that contact your breasts or your baby's mouth (i.e. soothers, nipples, bottles, breast pads, bras, and pumping equipment) The amount of yeast in your breast milk may increase during a yeast infection; if you store milk during this time, consider labelling this milk as later use may re-infect you and your baby Take medicine (Ibuprofen) for pain relief before or after breastfeeding if necessary Other family members may require topical or oral treatment if yeast does not clear Miconazole powder – so final concentration is 2% It may be helpful to add Ibuprofen powder to final concentration 2% (optional) Reference: Jack Newman, MD, FRCPC. 2003

Created by PRHA May 2011 with reference from: The Breastfeeding Service at Women’s Hospital


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