Well, what I meant by thrush in babies tending to "come back" was that thrush is yeast overgrowth.  We all have yeast in our mouths and on our skin.  It is supposed to be living in balance with the bacteria. Young babies tend to have trouble with this balance initially...I was taught that is because their immune system is not mature enough to keep it in check.

When we treat it, we cut down on the yeast population, but it is never "gone".  Just not high enough to cause a visible plaque.  So if the original reason for the overgrowth is still there, it may overgrow again soon.

If mom has symptoms of yeast, we treat mom and baby, even if baby has no visible signs. BUT if mom's symptoms do not improve at all with gentian violet, I keep looking for another cause.  Chronic pumping (for more than 2-3 weeks, more than 4 times/day usually) can cause hypoxic changes in the nipple that mimic yeast overgrowth in appearance and symptoms. So can vasospasm...causing it's own chronic intermittent hypoxia.

If this mom has burning, +/- shooting pain and red nipples/areolae, it is worth trying a heating pad on "low" over her clothes for at least 5 minutes after nursing or pumping. If this feels good and decreases her pain, she needs to do it after every feeding until the pain is gone.  And if the latch is still painful, that needs to be figured out.  Tongue-tie?  Recessed chin?

Kathy Leeper, MD, IBCLC, FABM
Breastfeeding Medicine Specialist
MilkWorks-nonprofit breastfeeding support center
5930 South 58th, Suite W, Lincoln, NE 68516
CELL(402)432-6867, FAX(402) 423-6422, www.milkworks.org


Creating a healthier community by helping mothers breastfeed their babies....


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