Yeast Infection of Nipple
Although not all painful nipples are caused by yeast infection, there is a possibility of yeast infection of nipple if nursing mother complaints of sudden severe unexplained pain or chronic pain in their nipples. Yeast infection of nipple is caused by the organism Candida albicans which is a fungus normally residing in warm moist areas of human body. These are opportunistic pathogens. Yeast infection of nipple occurs rarely in non-lactating women. However, in breastfeeding women the moist environment of nipple may provide the yeast with favourable conditions of growth. Damage to nipple such as cracks or fissures in the skin of nipple is also associated with higher risk of candida infection. There is increased risk of yeast infection of nipple in the women who use nursing pads; as these pads keep the nipple warm and moist. Some dietary factors particularly dairy products, foods rich in sugar and artificial sweeteners.
Although yeast infection may occur in healthy persons, it is more likely to occur in immuno-compromised individuals. It may cause serious infection in severely immuno-compromised people like transplant recipients, cancer patients, AIDS patients. Candida is normally present in almost all healthy persons. Most persons do not have problems with this as there is a balance between the other bacteria found on skin and the candida. When this balance gets disturbed due to any cause, the candida starts to overgrow and the benign yeast turns into pathogenic yeast. If the baby has oral thrush, yeast may get transferred to nipples. Recent treatment with antibiotics also predisposes to yeast infection.
Preventing Nipple Yeast Infection
- Expose the nipples to air after each feed to make them dry.
- Change the nursing pads after each feed.
- Avoid using plastic-lined breast pads.
- Use bleach solution to wash the pump part which comes in contact with breast and boil them in water for 5 minutes.
- Expose your nipples to sunlight daily for few minutes.
- Always wear cotton bra and dry them in sunlight after washing.
These simple measures may help to prevent yeast infection of nipple and may also cure a mild infection.
Signs and Symptoms
Pain is the most important symptom of yeast infection. It may affect one or both nipples. Mothers describe this pain as itchy-burning, throbbing, knifing which is severe and excruciating. Upon examination, nipple and areola may show following signs:
- Nipple may appear swollen and shiny. They may become sore and cracked and do not respond to other comfort measures.
- Nipples may remain more erect than normal.
- Skin rashes with tiny, fluid-filled blisters may be present.
- Skin of nipple may become dry and peel off due to yeast infection.
- White dots may appear over the nipple.
- Nipple may appear red or deep angry pink in light-skinned mothers.
- Nipple may appear darker or red in dark-skinned mothers.
- Some mother may suffer from recurrent infections.
Treatment of nipple yeast infection may be either topical or systemic. Topical treatment is attempted first. If the infection does not resolve with one or more topical treatment then physician will prescribe systemic treatment. If the yeast infection has affected the deeper tissues of the breast, then systemic treatment is required. Topical treatment for nipple yeast infection must be continued for 10-15 days after the symptoms resolve to prevent recurrence.
Applying antifungal cream containing miconazole, clotrimazole has to be applied to the nipples. These ointments are available without prescription of a doctor. Relief is usually noted within 24-48 hours of starting treatment; if not, talk to your health care provider to consider other treatment or to rule out other causes of nipple pain. Try using other antifungal medication, if one is not working because the strain of yeast you have might not be responding to one medication while it may respond to others. The nipples should be washed with warm water before feeding the baby. Single dose of fluconazole can cure a vaginal yeast infection but it is not sufficient to treat the ductal infection which lies and causes pain deep in the breast. To treat infection of deeper tissues of breast.
Gentian violet is another antifungal medication which is available without prescription. If the candida infection is not responding to standard treatments, then you can use 0.25-0.5 % gentian violet solution in consultation to your healthcare provider. It generally comes as 1% solution and must be diluted to appropriate concentration before use. Apply gentian violet to the nipples 2-3 times a day for three days. Gentian violet can also be applied to baby’s mouth. Get the details of applying methods before using gentian violet for your baby’s mouth, as this is a strong medicine and improper or prolong use may create problems. However, gentian violet treatment is recommended less frequently because of some studies saying that it is linked with cancer.
You may consider interrupting the breastfeeding temporarily if your nipples are too painful by using a breast pump. As it is necessary to keep the breast empty to prevent mastitis or yeast infection traveling deeper.
If the mother has yeast infection in the nipple, the baby should be treated for oral thrush even if the white patches are not visible in the baby’s mouth. Oral antifungal suspensions are available which can be painted on baby’s mouth. Doctor may prescribe an oral suspension containing nystatin which should be painted in baby’s mouth 3-4 times a day for few weeks. To apply the suspension, first pour the suspension in a clean small cup; dip a cotton swab in it and paint the whole mouth of the baby. If the baby has oral thrush but mother do not yet has nipple infection, applying the medication to baby’s mouth just before feeding will provide with the preventive benefit to the mother.
The popular belief is that dietary changes may help to cope up yeast infection. Taking less sugar containing foods and eating lot of yoghurt may help. Probiotic capsules containing acidophilus are also useful.