Using Gentian Violet
Gentian violet (1% solution in water) is an excellent treatment for Candida albicans. Candida albicans is a type of yeast that may cause an infection of skin and/or mucous membranes in both children and adults. In small children, this yeast may cause white patches in the mouth (thrush), or diaper rash. When the nursing mother has a yeast infection of the nipple, she may experience severe nipple pain as well as deep breast pain.
A few notes about Candida albicans:
- The baby does not have to have thrush in his mouth.
- A yeast infection of the nipple may be combined with other causes of soreness.
- Burning pain may be due to other causes, and pain due to a yeast infection does not necessarily burn.
Nipple pain caused by Candida albicans
The pain caused by a yeast infection is generally different from the pain caused by poor positioning and/or ineffective suckling. The pain caused by a yeast infection is often burning in nature, rather than the sharp, stabbing, or pinching pain associated with other causes. Not uncommonly, the pain will begin after a period of pain-free nursing. This characteristic alone is reason enough to try treatment for yeast. However, milk blisters on the nipple also may cause nipple pain after a period of painfree nursing. The pain frequently lasts throughout the feeding, and occasionally continues after the feeding has ended. This is in contrast to the pain due to other causes which usually hurts most as feeding begins, and gradually improves as the baby nurses. Also, the pain may radiate into the mother’s armpit or into her back. For some women, the pain is worse at night.
A yeast infection may be associated with recent use of antibiotics by the baby or mother, but not necessarily. It may cause no change in the appearance of the mother’s nipples or areolas, though there may be redness or some scaling, or the skin of the areola may be smooth and shiny. The infection may be quite severe and may or may not be itchy. Sometimes, the infection may occur only in the breast. At the same time, the breast appears or feels normal. This is not mastitis and there is no reason to treat with antibiotics. On the contrary, antibiotics may make the problem worse.
Using Gentian Violet
We believe that gentian violet is the best treatment of nipple soreness due to Candida albicans for the breastfeeding mother. This is because it almost always works and relief is rapid. It is messy and will stain clothing, but not skin. The baby’s lips will turn purple, but the purple will disappear after a few days. Gentian violet is available without prescription but is not available at all pharmacies. Call before going out to get it. Use the following steps to aid in treating a yeast infection with Gentian violet:
About 10 ml (two teaspoons) of gentian violet is more than enough for an entire treatment.
Many mothers prefer doing the treatment just before bed so that they can keep their nipples exposed and not worry about staining their clothing. The baby should be undressed to his diaper, and the mother should be uncovered from the waist up. Gentian violet is messy.
Dip an ear swab (Q-tip) into the gentian violet.
Put the purple end of the ear swab into the baby’s mouth and let him suck on the swab for a few seconds. The gentian violet usually spreads around the mouth quickly. If it does not, paint the inside of the mouth to cover as much of the inside of the cheeks and tongue as possible.
Put the baby to the breast. In this way, both the baby’s mouth and your nipple are treated.
If, at the end of the feeding, you have a baby with a purple mouth, and two purple nipples, there is nothing more to do. If only one nipple is purple, paint the other one with the ear swab and the gentian violet. In this way, the treatment is finished in one go.
Repeat the treatment each day for three or four days.
There is often some relief within hours of the first treatment, and the pain is usually gone or virtually gone by the third day. If it is not, it is unlikely that Candida was the problem, though it seems Candida albicans is starting to show some resistance to gentian violet, as it is to other antifungal agents. Of course there may be more than one cause of nipple pain, but after three days the contribution to your pain caused by Candida albicans should be gone. Do not continue the gentian violet if no relief occurs after 3–4 days of treatment. Instead, get more information.
There is no need to treat just because the baby has thrush in his mouth. The reason to treat is the mother’s and/or baby’s discomfort. Babies, however, do not commonly seem to be bothered by thrush. Uncommonly, babies who are treated with gentian violet develop sores in the mouth which may cause them to reject the breast. If this occurs, or if the baby is irritable while nursing, stop the gentian violet immediately, and contact the clinic. The sores clear up within 24 hours and the baby returns to feeding. All artificial nipples that the baby uses should be boiled daily during the treatment, or well covered with gentian violet. Consider stopping the use of artificial nipples.
If the infection recurs, treatment can be repeated as above. But if the infection recurs a third time, a source of reinfection should be sought out. The source may be the mother who is a carrier for the yeast (but may have no sign of infection elsewhere), or from artificial nipples the baby puts in his mouth. Treatment of the mother (usually with a medication other than gentian violet) at the same time as treatment is repeated for the nipples will usually eliminate reinfection. Contact your doctor.
This article appeared in Pathways to Family Wellness magazine, Issue #14.
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