Information Sheet and Care Plan for Yeast (Candida)
Candida (also called yeast, or thrush) is a fungus that occurs naturally in the mucous membranes and on the skin. Use of antibiotics promotes the overgrowth of yeast by killing off the 'good' bacteria that normally keep the yeast from multiplying too quickly. During pregnancy, yeast infections are more common because high levels of estrogen lead to elevated levels of sugar, and yeast feeds on sugar.
If you or your baby have recently been on antibiotics, if you have had a vaginal yeast infection during the last several months (or anytime during pregnancy), or if your nipples are cracked, then you and your baby are at risk for developing a yeast infection. Other factors that make you more susceptible to yeast include use of steroids or hormonal contraceptives, or chronic illness such as diabetes or anemia.
Symptoms of a yeast infection in your baby include creamy white spots or patches on the mucous membranes inside the mouth (gums, cheeks, or tongue). The spots may look pearly, and may be surrounded by redness. If you gently scrape the spot, it may be reddish underneath (unlike a coating of milk on the tongue). Sometimes the inside of the lips or the saliva may have a 'mother of pearl' appearance. The baby may be fussy and gassy, and sucking may be uncomfortable for him. He may pull off the breast, or may refuse to nurse at all. It is also possible for him to have an overgrowth of yeast but have no visible symptoms.
Yeast can also cause a rash in the baby's diaper area. The rash is red or bright pink, and may be scaly. The affected area may contain small raised red spots or sore looking pustules. The rash may be localized (the area looks like it has been dipped in scalding water) or it may be diffuse and lacy, covering a large area. Use of standard diaper rash medications like petroleum jelly or Desitin does not clear up a rash caused by yeast, and may actually make it worse, because yeast feeds on the oils found in greasy ointments, and also on the starch found in baby powders.
Symptoms in the mother include severe stinging, burning pain, which may be on the surface of the nipples, or may be felt deep inside the breast. Pain often continues throughout the feeding and in between feedings . especially immediately after. (Nipple pain caused by incorrect positioning and latch on rarely hurts except when the baby is nursing). Sometimes sharp, shooting pain radiates from the nipple into the breast or into the back or arm. Nipples are sensitive to light touch, so it may hurt to have clothes rubbing against them, and it may be very painful to take a shower and have the hot water spray touch the breast. Mothers describe the pain as 'liquid fire', 'hot needles', 'razor blades', 'a piece of glass stuck in my nipple', etc. I've heard many mothers say that they would rather go through labor again than have yeast on their nipples or in their milk ducts, which gives you an idea of just how painful this condition is.
The nipples may look puffy, scaly, flaky, weepy, or have tiny blisters. They may be itchy. The color is often a deep pink. The nipples may also look completely normal, but be terribly painful (just as the baby's mouth may be infected, but not have white patches). Generally, the nipples don't "look as bad as they feel", so there is often a tendency to underestimate the severity of the problem based simply on visual examination of the nipples. If you have yeast on your nipples, or if your baby has it in his mouth, your milk supply will often decrease. Pain inhibits the let-down reflex, and babies with yeast often do not nurse as efficiently as they do when their mouths are not sore. Yeast infections may also lead to plugged duct and mastitis.
Once the infection is cleared up, you should be able to build your supply up again quickly. It is important to note that while yeast on baby's bottoms or in their mouths may be tender and irritated, it does not seem to cause extreme pain like it does on the mother's nipples or in her milk ducts.
