Mycoses are infectious diseases caused by microscopic fungi, mainly candida. They are responsible for aphthas in the baby's mouths and for nipple fungal infections. Candidas occur naturally in the human digestive tract, but when their number is too high, this leads to problems such as mycosis.
Mycosis symptoms include itching and flaking of nipples which are painful and sore. The skin infected with fungi is reddened, tight, and seems to shine, easily cracks and bleeds. Sometimes, white spots/lumps appear on the nipple and the areola that cannot be rubbed off. The feeding mum feels piercing, stabbing pain in her breasts when the baby sucks, and also between feedings. The fungal infection in breast is often accompanied by the vaginal fungal infection.
When the mum is infected, usually the baby is infected as well, and the mycosis causes a rash (small, red pimples) around the genitals and aphthas in the form of whitish spots on oral mucosa (palate, gums, inner surface of cheeks, tongue), looking like milk remains which, however, bleed when you try to rub them off. Aphthas are not dangerous, but they may be painful for the baby and make suckling difficult.
A fungal infection of nipples may occur when:
mum or baby were taking an antibiotic (e.g., following C-section),
baby has aphthas, or skin mycosis in his crotch area,
mum often suffers from vaginal mycosis,
other members of the household suffer from mycosis,
cracked, bleeding nipples are incorrectly treated (e.g., are in contact with moist, rarely changed, non-breathable bra pads),
mum had mastitis,
mum uses hormonal contraception.
To combat the candida successfully, the following measures are necessary:
Treatment provided both to the mum and to the baby, even when the mycosis symptoms have appeared only in the mum or in the baby. In brief: Your "duo" must be treated together! Otherwise the mycosis will "wander" there and back again between you and your baby.
Use nystatin solution to rinse the baby's mouth (gums, palate, inner cheek surface, about 3–4 times a day) and your breasts (the nipple with the areola) after each feeding. Nystatin treatment should last from 10 to 14 days. Some doctors also recommend gentian violet solution in water for rinsing of the baby's mouth and mum's breast, or a special anti-fungal ointment applied on nipples and areolas. Moreover, the infected crotch area of the baby must be treated with appropriate formulation, rinsed with starch solution and frequently aired.
Introduce a probiotic formulation into your and your baby’s diet to help to restore the correct bacterial flora in your bodies.
Maintain hygiene. Wash your hands frequently (always before and after breastfeeding) and cut your nails short. Mum’s and baby's towels, underwear and pajamas must be changed frequently, washed at high temperature and ironed. Baby's toys and all pacifiers and accessories used during feeding must be frequently and thoroughly washed (and scalded, if possible).
During treatment, do not use sponges, washcloths or pumices, which accumulate fungi inside and support their multiplying.
Change lactation pads frequently, so they are not soaked through.
Air your breasts frequently.
Dry your breasts thoroughly before putting your bra on.
Following these tips you should see improvement already after a week - pain will disappear, and wounds will heal. If you do not see any improvement, contact a doctor, you may have a bacterial infection or mastitis. Or maybe healing is hindered by the incorrect position during feeding or incorrect breast grasping and suckling by the baby?
A fungal infection is not a contraindication to breastfeeding, particularly, as the treatment involves both the mum and the baby. When pain in raw nipples makes breastfeeding difficult to you, use painkillers with paracetamol or ibuprofen. And if that does not help, and pain during breastfeeding is unbearable to you, extract milk with a breast pump until the nipples heal. Regularly extracted milk should be given to the baby in a way not interfering with his breast suckling technique (remember to thoroughly wash and sterilize the pump parts).