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Dr. Bill and Martha Answer:
Can you recommend any treatments for thrush? Are herbal treatments OK?

Question:
I am breastfeeding two children and we seem to get thrush and/or yeast infections a lot. Can you recommend any treatments or suggestions? My son seems to get the yeast infection also. Will he be prone to this condition as he grows and stops nursing?

Also, if I take herbal supplements like chamomile, how much is passed through to my milk, and if I give my children child's chamomile, would I lessen the recommended dosage because I am nursing? I also read somewhere that tea tree oil can be taken orally to treat thrush, is this OK?



Answer:
Thrush is a fungus or yeast infection that thrives in warm, dark, moist environments, such as the mucus membranes of the mouth, vagina, diaper area, skin folds, bra pads and persistently wet nipples. Here are some simple suggestions that can prevent yeast infections of the nipple or cure a mild case:
  • Eat yogurt daily. Choose a brand that contains live and active cultures.
  • Yeast organisms hate sunlight, so give your bra and breasts a sunbath. Expose your nipples to sunlight for several minutes several times a day. Lay out your bra in the sunlight.
  • Air-dry your nipples after a feeding.
  • Avoid plastic-lined breast pads which irritate skin and trap leaked milk.
  • Change nursing pads at each feeding.
  • Wear 100 percent cotton bras and wash them and your breast pads daily in very hot water, using one cup of vinegar in the rinse cycle. Do a vinegar rinse on your areolas and nipples after each feeding. Use one cup of water to one tablespoon of vinegar and change the solution every day.
  • Apply an antifungal cream (mycostatin, clotrimazole, miconazole) to your nipples as directed by your doctor. Your healthcare provider may prescribe an oral anti-fungal suspension that should be painted on baby's tongue, roof and sides of the mouth three to four times a day for a couple of weeks. It's unusual for toddlers and older children to get thrush, so it's likely that this condition will subside once they are weaned.

Regarding your second question, herbal supplements, like chamomile, are safe to drink during breastfeeding. Even if some part of the herb passes through to your infant, it should be safe since chamomile given directly to infants is one of the oldest colic remedies. I'm not aware of tea tree oil being used to treat oral thrush, but it's worth a try.

For more information on thrush, see lactation consultant Mary Kay Smith's article series on Breastfeed.com.