Thrush, a common yeast infection, is caused by an overgrowth of Candida albicans, a fungus naturally present in the body. This infection can affect various parts of the body, including the mouth, skin, and, for breastfeeding parents, the nipples and breasts. A common concern for many breastfeeding parents is whether thrush can be transmitted through pumped breast milk. Thrush can indeed be passed through pumped breast milk, a relevant consideration for those managing milk expression during an infection.
How Thrush Spreads Through Milk
Candida albicans thrives in warm, moist environments, making areas like the mouth and nipples susceptible to overgrowth. Thrush can establish a cycle of transmission between a breastfeeding parent and their baby. An infected parent can pass the yeast to their baby during feeding, and in turn, an infected baby can transfer the fungus back to the parent’s nipples.
The yeast can enter pumped breast milk through several pathways. If the parent has a thrush infection on their nipples or within their milk ducts, the Candida can directly contaminate the milk as it is expressed. Additionally, contaminated pump parts, such as flanges or collection bottles, can introduce the yeast into the milk if not properly cleaned and sterilized.
Identifying Thrush in Mother and Baby
Recognizing thrush signs in both the infant and the breastfeeding parent is important for timely intervention. In infants, common indicators include creamy white spots or patches on the tongue, gums, roof of the mouth, or inside the cheeks. These patches often resemble cottage cheese and typically cannot be easily wiped away, revealing a red, raw, or even bleeding area underneath. Babies with oral thrush may also exhibit fussiness during feeding or refuse to feed due to discomfort. A persistent diaper rash that is bright red with satellite lesions can also suggest a yeast infection, potentially linked to oral thrush.
For breastfeeding parents, thrush often presents as nipple pain described as burning, itching, or stinging. This pain can range from mild to severe, often intensifying during or after feeds, and may persist for an hour or more. The nipples might appear shiny, flaky, or unusually red or deep pink. Some individuals also experience deep breast pain, which can manifest as a stabbing, shooting, or aching sensation radiating through the breast. This pain may occur in one or both breasts and might not resolve with adjustments to feeding position or latch.
Handling Pumped Milk with Thrush
Managing pumped milk during a thrush infection requires careful consideration, as the yeast can be present in the milk. While some parents might choose to discard milk pumped during an active infection to avoid potential re-infection, this is not always necessary. Freezing breast milk does not eliminate Candida yeast; instead, it only inhibits its growth. This means that while freezing can preserve the milk, the yeast remains viable and could become active again upon thawing.
Despite the presence of yeast, milk expressed during a thrush outbreak can often be used safely, especially for healthy infants. Some research suggests that freezing milk with yeast does not pose a significant risk to healthy babies. If concerned about using previously frozen milk, heating it to 63°C (144.5°F) for 30 minutes can kill the yeast, or heating it to 50°C (122°F) for less than 5 minutes can also be effective. Label any milk pumped during a thrush infection. Consulting a healthcare professional for personalized advice regarding milk usage is recommended to ensure the best approach for both parent and baby.
Treating Thrush and Preventing Recurrence
Effective treatment for thrush involves addressing the infection in both the parent and baby simultaneously to interrupt the cycle of re-infection. For infants, common antifungal medications include nystatin oral suspension, applied directly to the baby’s mouth and tongue several times a day. For parents, topical antifungal creams are often prescribed for the nipples and areola. In some cases, oral antifungal medications, such as fluconazole, may be prescribed, especially for more persistent or severe infections.
Preventative measures and hygiene practices are important to prevent recurrence. All pump parts, bottles, pacifiers, and toys that come into contact with the baby’s mouth should be sterilized daily, by boiling items for 5-10 minutes. Frequent handwashing, especially after diaper changes or before handling feeding equipment, helps prevent spread. Changing breast pads often and allowing nipples to air dry after feeding can also help reduce the moist environment where yeast thrives.