Feature Article:::...

Diflucan good treatment for nipple/breast yeast in nursing mothers

By: Becky Flora, IBCLC

Breastfeeding moms often suffer from yeast infections (candidiasis) of the nipple and breast. Unfortunately, many practitioners do not recognize the symptoms of the condition or fail to treat it properly.

Nipple and breast (ductal) candidiasis can occur when the mother has had antibiotics during pregnancy, labor/delivery, or at any other time while she is breastfeeding. Sometimes yeast infections will occur after the nipples have been severely traumatized due to a faulty latch or suck. Many times the cause is not known and some mothers just seem more prone to these type of infections.

Yeast on the nipples can cause the nipples to be very sore, red or pink, cracked, itchy, peeling and swollen. Not all of these symptoms have to be present and quite frequently the nipples may look perfectly normal but the mother will complain of intense pain. She may also present with vaginal yeast and the baby may have a yeasty diaper rash and/or thrush in the mouth.

Breast or ductal candidiasis presents as shooting, stabbing, burning pain within the breast itself. Anytime a mother complains of nipple soreness and/or breast pain immediately following birth, for more than one to two weeks postpartum, or at any other time while she is breastfeeding following a period of pain-free nursing, yeast should be suspected. This is especially true if either mother or baby has been recently treated with antibiotics.

It is a myth that nipple soreness is to be expected following birth. Normal tenderness may occur during the early days of breastfeeding, peaking at about day four, but this is quite different than the pain associated with a yeast infection.

Treatment can involve many different natural, prescription and over-the-counter remedies, all of which work to varying degrees. For this article I want to focus on the use of Diflucan since it is very effective and very safe for treating this condition in nursing mothers, but often overlooked, under-prescribed, or even refused due to incorrect information.

Diflucan (fluconazole) is an antifungal or anti-yeast medication taken orally. Very little of the drug passes into breastmilk, so little that if the baby’s provider wants to treat the baby with Diflucan, the child must have his own dose as he will not receive enough through his mother’s milk for successful treatment. Some health-care professionals alarm mothers unnecessarily about liver damage when taking Diflucan. This is truly rare in healthy people.

The dosage of Diflucan for treating nipple/breast yeast is significantly greater than that used to treat vaginal yeast, and this often poses a problem when a mother turns to her doctor seeking treatment. Current literature suggests an initial dose of 200 to 400 mg followed by 100 to 200 mg for 10 to 14 days thereafter. Some mothers may need to repeat this dosage if the yeast seems especially resistant. The FDA has also approved the use of Diflucan for infants older than 6 months and it has safely been used in neonates as young as 1 day old.

When a mother has a yeast infection, she has a variety of treatments in her arsenal. However, because yeast can be very difficult to get rid of, often an oral medication such as Diflucan is more effective than the use of topicals. It may just assure that this mother is able to continue breastfeeding and providing her baby with all its benefits. Unfortunately, mothers denied appropriate treatment for yeast often prematurely wean due to the persistent pain they experience.

For more information:

“Medications and Mothers’ Milk” (2003) by Thomas Hale, Ph.D

“Fluconazole” article by Dr. Jack Newman found at breastfeedingonline.com

For more information on treating yeast, see “Could We Have Thrush?” found at breastfeed-essentials.com/thrush.html

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Becky Flora is a board certified lactation consultant (IBCLC) in practice with Breastfeeding Essentials in Kingsport. Visit her Web site at breastfeed-essentials.com