Thrush (candidiasis) is a common yeast infection affecting infants and breastfeeding parents. This fungal overgrowth causes discomfort for both, often leading to a painful cycle of re-infection. While expressing milk does not create the infection, breast pumps can become mechanical carriers for the fungus. Understanding how the organism thrives and how equipment is involved is important for managing and preventing its spread.
Understanding Thrush and Its Cause
The organism responsible for thrush is a yeast called Candida albicans. This yeast typically resides on the skin, in the digestive tract, and in the mouth without causing issues. Problems begin when the delicate balance of the body’s natural flora is disrupted, allowing Candida to multiply excessively.
Factors such as recent antibiotic use, hormonal fluctuations, or a compromised immune system can encourage this overgrowth. Antibiotics, for instance, eliminate beneficial bacteria that normally keep the yeast population in check. Thrush is the name given to the symptoms that occur when Candida begins to overgrow and cause an infection.
How Pumping Facilitates Transmission
A breast pump does not create a thrush infection, but it can easily become a vector for transmission and re-infection. When an infected parent pumps, Candida spores present on the skin of the breast or nipple are transferred directly onto the pump parts. The warm, moist environment within the pump assembly, particularly on plastic components like flanges and valves, is an ideal breeding ground for yeast.
If the equipment is not thoroughly cleaned and sanitized after every use, the Candida can adhere to the surfaces of the pump parts. The next time the parent pumps, the yeast is reintroduced to the breast, perpetuating the infection cycle. This contaminated equipment can also transfer the fungus to expressed milk and bottles.
Recognizing and Addressing Infection
Recognizing the symptoms of thrush is the first step toward effective treatment. For the nursing parent, symptoms often include deep, burning pain in the nipple and breast tissue lasting up to an hour after a pumping session or feeding. The nipples may appear shiny, flaky, or unusually dark pink, and the skin may be sensitive to touch.
In infants, oral thrush presents as creamy white patches inside the mouth, on the tongue, cheeks, or gums, which often do not wipe away easily. The baby may also become fussier during feeds, pull off the breast repeatedly, or develop a persistent, angry-looking diaper rash. Upon suspicion of infection, seeking advice from a healthcare provider or lactation consultant is necessary.
Thrush requires simultaneous treatment for both the parent and the baby to prevent them from passing the infection back and forth. Simply cleaning the pump is insufficient once an active infection is established. Treatment usually involves topical antifungal creams for the parent and an oral gel or liquid for the baby.
Strict Cleaning Protocols for Pumping Equipment
To prevent the pump from acting as a vector, cleaning and sanitization protocols must be followed. All pump parts that come into contact with breast milk, such as flanges, valves, and connectors, must be disassembled and cleaned after every use. The parts should first be rinsed in cool water to remove milk residue, then washed thoroughly with dish soap and warm water in a dedicated wash basin.
After washing, rinse the parts with fresh water and allow them to air-dry on a clean paper towel or drying rack, avoiding the use of cloth towels which can harbor germs. When there is an active thrush infection, sanitization is required daily to kill the yeast spores. This can be achieved by boiling the disassembled parts for five minutes or by using a steam sterilizer, following the manufacturer’s instructions.
What to Do With Contaminated Milk
Parents who are actively treating a thrush infection should understand the safety of their expressed milk. Milk pumped during a thrush outbreak is safe to feed to a healthy, full-term baby while both are undergoing treatment. The yeast present in the milk is not harmful to the infant in this context, especially when consumed immediately after pumping or refrigeration.
However, caution is necessary when freezing milk pumped during an active infection. Freezing deactivates the yeast but does not kill it, meaning the milk could cause a re-infection upon thawing later on. If milk is frozen, it should be clearly labeled and ideally used only while the baby is still being treated, or it can be heat-treated before feeding to eliminate the Candida.