Thrush Infection in Breastfeeding Mother and Infant | University Hospitals | Northeast Ohio

Thrush is another name for a yeast infection. Yeast grows rapidly in warm moist areas. A yeast infection may be present on mother’s nipples or breast or in your baby’s mouth or diaper area. Sometimes both mother and baby have a yeast infection, or only one person has a yeast infection. To prevent the spread of yeast, wash your hands frequently when touching your breast, baby’s mouth or baby’s diaper area. Below are symptoms you or your baby may experience if a yeast infection is present.

Some Signs of Thrush for Mothers

• Red or deep pink nipples or areola.
• Nipples may be shiny with peeling, flaky skin and may itch. A rash may be present with tiny blisters.
• Sore or cracked nipples that don’t respond to basic treatment or the sudden onset of sore nipples after a period of comfortable nursing.
• Sore nipples throughout a feeding despite good positioning and latch.
• Burning or shooting pain the breast during or after a feeding.
• Nipple and/or breast pain while pumping correctly, using a good automatic breast pump and correctly sized breast flange.
• Current vaginal yeast infection or history of repeated vaginal yeast infections.
• Recent use of antibiotic may put you at increased risk of a yeast infection.

Some Signs of Thrush for Babies

• Baby’s mouth has white patches surrounded by diffuse redness.
• Diaper rash (red or red with raised bumps).
• Baby is fussy, gassy and cranky.
• Baby repeatedly pulls off the breast or refuses breast. Your sexual partner may also have a yeast infection.

If both you and your baby have symptoms of yeast, both of you should be seen by a healthcare provider and treated. Some healthcare providers will treat both mother and infant at the same time, even if one does not have symptoms.

Treatment for Yeast Infection

• Your healthcare provider will probably prescribe an antifungal medication. FOLLOW PRINTED INSTRUCTIONS listed on your medication.
• Instructions usually recommend placing the antifungal medication in the baby’s mouth using a medicine dropper after feedings and swabbing medication over baby’s gums and tongue.
• If your baby has yeast present in the diaper area, antifungal cream or lotion may be applied to baby’s entire diaper area.
• Antifungal cream or lotion can be applied to mother’s nipples or breast before and after feedings.

General Recommendations

• Air dry nipples and if possible, expose them directly to the sun for a few minutes twice a day.
• Throw away disposable breast pads as soon as they are wet.
• Wear 100% cotton underpants and bras. Wash in very hot water and use bleach to kill yeast spores.
• Restrict alcohol, cheese, bread wheat products, sugar and honey which promote the growth of yeast.
• Avoid bathing with other members of the family.
• Use condoms during sex to avoid cross infections with a sexual partner.
• Talk with your healthcare provider concerning possible use of acidophilus tablets.
• Boil items daily that come in contact with your breast or baby’s mouth such as: breast shells, breast/pump flanges, pacifier, bottle nipples, teething toys, etc. for 20 minutes.
• If you are unable to boil items, soak items in a vinegar and water solution for 30 minutes.
• Thrush infection passes easily to other people. Avoid skin to skin contact, wash hands frequently, and do not share towels.

Do not freeze expressed breast milk until you have completed your course of medication and are symptom free. Freezing breast milk does not kill yeast.

Works Cited

Lawrence, Ruth A. & Lawrence, Robert M. “Breastfeeding, A Guide for the Medical Professional”, Eighth edition, ELSEVIER, 2016.

Wambach, Karen and Riordan, Jan “Breastfeeding and Human Lactation”, Fifth edition, Jones & Bartlett, 2016.

USDA WIC Breastfeeding Support Plugged Ducts, Mastitis, and Thrush. Retrieved 21 August 2020.

Breast Yeast Infection

Candida infections of the nipples may occur any time while the mother is breastfeeding. Candida albicans likes warm, moist, dark areas. It normally lives on our skin and other areas, and 90% of babies are colonized by it within a few hours of birth. It, like many other germs that live on us normally, only becomes a problem under certain circumstances.

Candida infections of the skin or mucous membranes are more likely to occur when there is a breakdown in the integrity of the skin or mucous membrane-one of the reasons why a good latch is very important from the very first day. Many Candida infections would, perhaps, not have occurred if the mother had not had sore nipples and a breakdown of the skin of the nipples and areola. The oozing of liquid that occurs often from cracked nipples encourages Candida albicans to change from its harmless form to an invasive form.

The widespread use of antibiotics also encourages the overgrowth of Candida albicans. Many pregnant women, women in labor, and new mothers, as well as their babies receive antibiotics, which can increase the chances of yeast occurring. 

If the recommendations below are not effective, and nipples remain sore, call your OB provider.

Breast Yeast Infection

• If you have nipple pain that begins after a period of pain free nursing, yeast should be ruled out by mother and baby MD.
• If you have burning nipple pain that continues throughout the feeding and sometimes continues after the feeding if though the baby is nursing well, yeast should be ruled out.
• If you have pain in the breast that is “shooting” or “burning” and it seems to go through to the mother’s back and shoulder and tends to be much worse at night, call your MD.

Once treatment is begun, you should see some improvement in 1-2 days. Remember that both mother and baby must be treated at the same time. Ask baby’s MD to check for both oral thrush & candida diaper rash.

Mother

Wear a clean washed cotton bra daily. Use disposable bra pads without waterproof liners. Change pads after each feeding.  If using disposable breast pads, boil them in vinegar water solution for 5 minutes after washing.

Hygiene

• Wash hands frequently. Keep nails clean and short. Use a nail brush to scrub under your fingernails.
• Use a clean towel for each bath or shower.  Do not let damp towels hang in bathrooms or kitchen.  Consider paper towels for drying hands.
• Wash all bras, towels, wash clothes, and baby’s burp clothes in hot soapy water daily.
• Wash all breast or pumping equipment that touch your breasts or breast milk in hot soapy water after each feeding/use.  Boil 5 minutes daily in the vinegar water solution. You may wish to consider using a microwave steam sterilizer bag which quickly sterilizes baby bottles and parts.
• Boil infants nipples &/or pacifiers or toys that go in baby’s mouth in vinegar solution for 5 minutes daily (or use a microwave steamer bag).   Replace nipples/pacifiers after 10 days of treatment.  Clean baby’s toys with vinegar and water to prevent another infection.

Diet

• Avoid sugary foods, cheeses, breads or alcohol until treatment is complete.
• Add live culture to your diet once or twice a day. Try yogurts low in sugar, probiotics or acidophilus (viable units) (1 capsule TID x 4 days).

Breast Milk

• While you and baby are being treated for yeast, your refrigerated, fresh, or milk frozen during thrush treatment can be used safely for baby.
• Freezing deactivates yeast, but does not kill it, so label all milk pumped and frozen during a thrush outbreak.
• If you wish to further minimize baby’s risk: when you thaw/use the frozen “thrush” milk, dilute it by mixing it with milk expressed at a different time, or “heat treat” the defrosted “thrush” milk by heating it for a couple of minutes to a temperature of 122 degrees F (50 degrees C. ).  Some “scald” milk which heats milk just until it begins to steam.  (This is a much higher temperature and destroys most of the antibodies in breast milk, but it is still much more nutritious than formula)

Baby

• Use oral Nystatin liquid medication as prescribed by MD.  You may wish to try using half the dose 8 times a day instead of 4 as usually prescribed.  Place medication in a small cup, coat all over the inside of baby’s mouth with a Q-tip or clean finger.  Give any leftover medication to baby from the dropper.  Use medication for at least 14 days.
• Some MD’s prescribe diflucan for baby to treat thrush.
• The pharmacist will direct you on how to give it to your baby.
• Call baby’s MD if baby gets a rash in the diaper area

Urinary tract infection in newborns.

Urinary tract infection in young children is no less common than viral respiratory infections. Vomiting and nausea, cramps in the abdomen are often attributed by parents to colic, malnutrition or intestinal infections. However, with such symptoms, it is recommended to consult a doctor. If this is a urinary tract infection, then its untimely diagnosis and treatment will lead to unpleasant consequences for the baby.

A urinary tract infection occurs when bacteria in the child’s body begin to multiply rapidly in the urinary tract.

Most often this pathology is caused by microbes such as:

– Escherichia coli,

– Staphylococcus aureus,

– Pseudomonas aeruginosa,

– Klebsiella

Often infections in infants develop against the background of malformations of the urinary tract.

These include:

– vesicoureteral reflux;

– narrowing of the ureters;

– malposition of the organs of the urinary system;

– horseshoe kidney and others

Another cause of infection is the presence of a microbial focus in the body. With an infectious-inflammatory pathology of other organs, the bacterial flora can enter the kidneys and urinary tract, causing inflammation there. Also, the bacterium can enter the baby’s body from the mother during breastfeeding.

Genitourinary infection in infants presents with the same symptoms as in adults. The problem is that a newborn baby cannot complain.

Parents should keep a close eye on their child to detect symptoms of illness.

Initial symptoms include tearfulness, restlessness, poor sleep and loss of appetite.

In children under one year old, a urinary tract infection may be manifested by a decrease or increase from the age norm of urine excreted, a change in the color and saturation of urine (the child’s urine may become bright yellow (with an increase in the concentration of urine, which is usually accompanied by a decrease in its quantity), red or brown (admixture of blood.) When bacteria appear, the urine does not change its color, but becomes cloudy and loses its transparency. 0003

Edema may appear due to the characteristics of the baby’s body, the appearance of an unpleasant smell from the diaper.

The appearance of restlessness and crying when urinating, which indicates the presence of pain and cramps in the baby. Often, mothers note that the child strains when urinating. In this case, an intermittent stream of urine is recorded.

The rise in temperature to high numbers, if it does not go away after taking antipyretics and persists for several days, this is a reason to suspect an infection.

Infection of the genitourinary system in infants is detected by laboratory analysis of urine, urine culture, blood test, b / x blood test.

In case of inflammation, blood and urine tests show an increase in the number of leukocytes. With bakposev, it is possible to identify which bacterium caused the infection, and determine the individual sensitivity of the microbe to the antibiotic.

As noted above, the cause of infection in infants may be a congenital malformation of the genitourinary organs.

If this pathology is suspected, the following examinations should be performed:

– ultrasound examination of the urinary system organs;

– voiding cystography;

– retrograde radiography of the kidneys;

– CT or MRI of the kidneys.

The basis for the treatment of urinary tract infection is antibiotic therapy. A broad-spectrum antibiotic or a drug based on sensitivity is prescribed. The antibiotic is taken orally or injected intravenously.

It is important that if an infection is detected, the infant must be hospitalized for the duration of treatment.
In addition to antibiotics, anti-inflammatory drugs and antipyretics are used. Moreover, many medicines are produced in a convenient form of application, for example, in candles.

Herbal uroseptics are often prescribed, which do not have a toxic effect and contribute to the recovery of the child. In no case should you start treatment on your own or cancel medications without a doctor’s prescription. This will lead to the fact that the disease will go into a latent stage and will periodically worsen, again and again causing unpleasant symptoms. In addition, many drugs are contraindicated for children and their uncontrolled use will bring irreparable harm to the child.

Infection in infants with malformations will constantly recur despite good treatment. Therefore, the only way out is to carry out an operational correction of the defect. It should be noted that the operation is possible only after the acute inflammatory process is eliminated.

Prevention of urinary tract infections in infants.

In order to rule out an illness in a child, the following points should be followed:

– Carefully monitor the hygiene of the child’s urinary organs.

– avoid hypothermia of the baby;

– monitor the rationality of nutrition.

Every year about 1400 children are treated in the Department of Prematurity and Pathology of Newborns. Of these, with urinary tract infection 65-70, with various congenital malformations of the kidneys and urinary system 28-30 children. All children undergo a complex of examinations and treatment according to the developed standards. All children are discharged with improvement and recovery and are subsequently observed by nephrologists and urologists in the regional children’s clinic.

Infection of the genitourinary system is not such a terrible diagnosis. With a complete examination and high-quality, adequately selected therapy, the child will recover without any residual effects.

How to treat stomatitis in a child?

Stomatitis in children

Stomatitis is an inflammation in a child’s mouth that can cause sores on the tongue, gums, cheeks and throat. This situation is more common in children under the age of 3, but can also occur in adolescence. In most cases, stomatitis is caused by the herpes virus, and in this case is called herpetic gingivostomatitis.

Treatment is based on a pediatrician who recommends that the child’s mouth be kept clean at all times and that medication be used to relieve symptoms and, in some cases, relieve discomfort.

What can cause stomatitis in children?

Stomatitis can occur for several reasons, but the most common causes are:

• reduced immune system defenses,
• habit of putting dirty hands and objects (toys) in the mouth,
• as a result of infection with influenza viruses, herpes simplex or varicella, Coxsackie, enteroviruses,
• candidiasis (thrush).

Other pathogens are bacteria and fungi. Also, the cause may be temperature or mechanical injuries of the oral cavity, allergic reactions. Deficiency of vitamins B or C plays a role.

Main symptoms

Children’s stomatitis usually presents with symptoms such as irritability and poor appetite, because when food enters the wound, it causes pain. Other symptoms that may occur with stomatitis:

• Mouth ulcers or inflammation of the gums;
• Pain in mouth and throat when swallowing;
• Temperature may be over 38 °C;
• Wounds on lips;
• Bad breath.

These symptoms may appear simultaneously, but most often only ulcers appear. In addition to stomatitis, there are other diseases that can cause mouth ulcers, such as the Coxsackie virus, which causes foot-and-mouth disease. Therefore, it is important that the pediatrician assess the symptoms in time and do tests in order to correctly diagnose.

What is observed in the mouth of a child with stomatitis?

On examination, there may be painful erosions, ulcers, and blisters on the lining of the inside of the cheeks, gums, lips, tongue, and, less commonly, the back of the throat. Enlarged lymph nodes in the neck and under the lower jaw are also common.

Gums may be slightly swollen, red, ulcerated and bleed easily.

When the cause is viral, oral lesions may last 7 to 10 days, although general symptoms resolve sooner.

Can the pathogen be easily diagnosed?

Microbiological examination can be carried out, but the methods used are not simple.

Samples must be transported and cultured in a suitable medium. Results will be available in approximately 15 days. Rapid diagnostic methods are also available, such as direct staining of the contents of the vesicles with fluorescent antibodies.

Is there any specific treatment?

Treatment of stomatitis must be prescribed by a pediatrician or dentist and lasts approximately 2 weeks. However, it is important to be careful with the food the child eats and maintain proper oral hygiene to avoid the multiplication of microorganisms in the ulcer.

Most often, gingivostomatitis resolves spontaneously and requires only symptomatic pain management or antiseptics to aid local healing. In children, special attention should be paid to their hydration by offering them liquids in fractional form, cold or at room temperature. Sour, salty or spicy foods should be avoided.

Discomfort can be reduced with paracetamol or ibuprofen taken by mouth. If a yeast infection is suspected, topical application or antifungal rinses are usually effective. In some cases, the use of antiviral drugs such as acyclovir may be recommended for gingivostomatitis caused by herpes viruses. This medication helps heal wounds in the mouth, but should only be used with a pediatrician’s prescription. Therapy of herpes infection with acyclovir is not required for mild infection in children with sufficiently strong immunity.

How to feed an infant or child with stomatitis?

It is important that the baby’s feeding is not interrupted when there is an illness. However, it is important to be careful to avoid aggravating symptoms:

• Avoid acidic foods such as orange, kiwi or pineapple;
• Offer cold liquids such as fruit juices or smoothies;
• Eating pureed or liquid foods such as soups;
• Choose cold foods such as yogurt, fruit compotes and gelatin.

How can stomatitis be prevented?

Herpes simplex infections are common in schoolchildren. Most of these infections are asymptomatic, the virus is shed in saliva in the absence of clinical manifestations of the disease.