RECOMMENDED TREATMENT:
Treat both mother and baby, even if only one has symptoms. You may
need to call your doctor as well as your baby's doctor. Treat your
sexual partner or any family member (siblings) with signs of
infection.
Mother:
Rinse the breasts with clear water after each breastfeeding.
Your doctor will recommend one of the following
medications: Nystatin (mycostatin), Monistat (miconazole),
or Lotrimin (clotrimazole). Put the cream on the nipple and
areola of both breasts after each
breastfeeding for 14 days.
If the pain is severe, use one of the above medications with
cortisone (Mycolog,
Lotrisone) for the first 1-3 days. Gently
massage the
cream into the nipples. It is not necessary to
remove the
cream before breastfeeding.
Wash bras in hot, soapy water each day and rinse well. Boil
all pump parts
for 20 minutes each day.
Wash your hands carefully before each breastfeeding and
after each
diaper change.
Use condoms during sex. Do not let your
partner's mouth
come into contact with your breasts.
Baby:
Your baby's doctor will prescribe medication in
liquid form,
Nystatin (mycostatin) for the baby's mouth, and in
cream
form, Monistat
(miconazole) or Lotrimin (clotrimazole) for
the
baby's diaper area. The cream used on the mother's
nipples also
can be used on the baby's bottom.
Paint the liquid on the inside of the baby's
mouth (cheeks,
gums, tongue, and roof) after each breastfeeding,
using a
clean cotton swab for each part of the mouth.
Do not put a
used cotton
ball back into the medicine bottle.
Put the cream on the red rash in the diaper area
during each
diaper change.
Boil all rubber nipples and pacifiers daily for
20 minutes.
Replace with new ones after the first and second week
of
treatment.
Mother and baby:
Expose your breasts and your baby's bottom to air
and
sunlight.
Avoid sunburn.
Change breast pads and diapers frequently. Do not
use pads
with plastic liners.
If the infection continues:
If signs of infection remain after 14 days of
treatment, the
fungus may be resistant to the medicine in the cream.
You
can choose a different cream and treat for 4-6 weeks or
apply a
1 % solution of gentian violet once a day for 3 days.
Using a cotton
swab, paint the solution on the nipple and
areola of both breasts
and on the inside of the baby's mouth
(cheeks, gums, tongue, and
roof). The purple solution will
stain the skin and clothing, so wear
an old bra and T-shirt.
Resistant infections that do not respond to creams
or solutions
can be treated with pills or tablets taken by mouth.
Your
doctor may prescribe fluconazole (Diflucan), 100-200mg a
day
for 14 days. You may want to avoid foods that support
the growth of fungus, such as alcohol, sugar, dairy products,
wheat, nuts, peanut
butter, dried fruits, and fruit juices.
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