Treatment and Relief for Mom

• If prescribed, take daily medication, such as oral Nystatin or Diflucan, as directed.
• If oral medication is not prescribed, use antifungal agents to rub on nipples. See the article Could You Have a Thrush Infection? for more information on topical antifungal drugs.
• After feeding, use a vinegar rinse on nipples. Pat nipples dry (try paper towels) and apply antifungal cream.
• Gentian violet is another effective option. It can be applied to mother’s nipples and areola twice daily. Use a fresh cotton swab for each breast. Warning, it stains!
• Expose the nipples to air when possible. Keep the nipples and areola dry. If nipples are too painful to tolerate the touch of clothing, you can wear breast shells in your bra.

Dietary Changes for Mom

• Reduce sugar intake and eliminate artificial sweeteners from the diet. Yeast may cause you to crave sugary foods, cheese, bread or alcohol. Decrease consumption of these until treatment is completed. Some women also will need to reduce intake of all dairy products.
• Take six capsules of acidophilus evenly spaced throughout the day. Refrigerated capsule forms with "live" cultures are most effective. Adding plain yogurt to the diet is good as well, but you may be eating yogurt all day!
• Add garlic or garlic capsules to the diet. Garlic is an anti-fungal and an immune system booster.

Hygiene for Mom

• If you are using a breast pump or wearing breast shells, wash after each use and boil all parts that touch the breast or the milk in water with ¼ cup vinegar added daily.
• Wash hands often, especially after using the bathroom or changing a diaper and before and after expressing milk or feeding the baby (milk is a perfect growth medium for the yeast organism). All family members who change diapers or feed the baby should follow these guidelines. Use paper towels to decrease the risk of growth on damp towels.
• Use disposable nursing pads, but avoid those with a plastic liner, which will cause you to retain moisture.

Treatment and Relief for Baby

• If prescribed, use oral Nystatin solution every three hours, using a clean cotton swab. Gently rub around cheeks and gums.
• Yeast replicates quickly (within 30 minutes to one hour), so medication that is orally swabbed may need to be repeated frequently. Try dividing up the days doses or applications into more frequent applications.
• Be sure that the medication for baby’s mouth is shaken well. Oral Nystatin settles out of the liquid in which it is suspended.
• Oral Diflucan has been cleared by the FDA for use in infants older than 6 months of age. It is given once a day for 10 days to 2 weeks.
• If baby is getting medication through an eyedropper, wash it with hot soapy water and rinse well before replacing in the bottle of medication. Some mothers use a disposable cup and cotton swab to apply medication to the baby’s mouth to avoid contamination.
• Gentian violet is an effective non-prescription option. It should be applied only twice daily to the oral surfaces of baby’s mouth (i.e. tongue, gums, lips). Use a fresh cotton swab every time. A little bit of Lansinoh or PureLan can be rubbed on baby’s lips prior to application to reduce staining. This is not the time to schedule a family portrait or baby photos!
• Some babies will suck acidophilus off mom’s finger. Use only 1/4 to 1/3 of a capsule’s contents about three times per day.
• Milk that has been expressed during an episode of thrush may harbor yeast. Freezing or refrigerating will not kill yeast in milk. Discard within 24 hours of pumping if not used to feed baby.
• If baby has a diaper rash, be sure to keep his/her bottom clean and dry. Let baby’s bottom air dry several times daily if possible.
• Rinse after each diaper change with vinegar solution (1 tablespoon white or cider vinegar to 1 cup sterile water). Apply antifungal cream after the vinegar rinse.
• Do not use baby wipes. They contain alcohol that can burn delicate skin and feed the yeast growth. Clear water followed by a vinegar rinse is sufficient.
• Plastic pants or disposable diapers can aggravate the condition. Try removing the outer layer of plastic on the disposable diapers at night and lay baby on an absorbent pad.

Hygiene for Baby

• Remember that babies like to put their hands in their mouths! Wash the baby’s hands gently before each feeding and dry with a soft paper towel. Little fingers are a warm, moist growth medium for yeast.
• Anything that goes into baby’s mouth should be sterilized daily. Be sure to discard all teething toys, bottle nipples and pacifiers and replace as the course of medication and/or treatment is completed.
• If baby uses a pacifier or rubber nipples, they should be boiled daily in water with 1/4 cup vinegar added. Replace all rubber nipples after a week of treatment.
• Any toys that go into the mouth can be wiped with vinegar and water or a weak bleach solution. The dishwasher can "sterilize" these items as well.

Household Modifications:

• Damp towels can harbor yeast. Use paper towels to affected areas of baby and mom and discard.
• Be sure to use paper towels in the bathroom and kitchen for the whole family and cleaning during an outbreak of thrush.
• Use all towels, bras and re-usable bra pads only once and wash in very hot water with bleach. Vinegar in the final rinse helps kill yeast as well. Too much bleach can cause holes in your clothes.

It’s important to identify all the carriers of yeast in the family, in addition to Mom and baby, and treat everyone affected -- or else the yeast will be passed back and forth. Yeast overgrowth can take the form of jock itch or athlete’s foot in Dad or anyone else in the family. Dandruff also can be related to yeast. Check the pets, too -- animals can harbor yeast, especially in a damp climate or humid weather.

All measures mentioned should be used for at least two weeks after symptoms are gone, or as directed by your healthcare practitioner.