1) Sterilizing or throwing out things
The Candida present in and on the person is the cause of most infections. Candida is less commonly acquired from inanimate objects (fomites) (Hota 2004). Consider that Candida albicans is found in:
- The skin, mouth, or gut of 30-60% of the population.
- The vaginas of 20% of women.
- As many as half of the mouths of babies.
- The milk of some mothers.
Eliminating Candida from the household is unlikely if some of the members are hosts, as it can be transmitted from person to person.
A variety of fungi, including Candida, are also present on indoor surfaces and can survive for months making “sterilizing” of a household very difficult if not impossible (Adams 2013; Kramer 2006).
Therefore, the following will not treat or prevent infections:
- Boiling or sterilizing bras and other clothing.
- Sterilizing the baby’s toys.
- Sterilizing pump parts more than is recommended.
2) Washing nipples and areolas
Washing nipples and areolas can increase the risk of nipple yeast infection and other problems because washing:
- Can remove normal oils and dry the nipples, allowing Candida and bacteria to enter.
- Can cause other problems when various products are used.
3) Changing the diet or avoiding certain foods
There is little evidence that supports using a specific diet to treat or prevent nipple yeast infections.
Candida diets were popular a few years ago and focused on:
- Increasing intake of vegetables and proteins and avoiding refined sugars and carbohydrates.
- Avoiding sources of “yeast”.
- Consuming probiotic-laden foods or probiotic preparations.
A healthy, balanced diet can increase overall well-being, but there is no conclusive evidence diet affects Candida colonization or infection.Foods containing probiotics such as yoghurt and kefir can be part of a healthy, balanced diet. There is very limited evidence for the use of probiotic preparations.
There is no point avoiding certain foods out of concerns that they carry Candida. The following foods are not prepared with Candida but with other members of the fungus family, and mothers don’t need to avoid the following:
- Fermented foods
- Blue cheese
- Yeast-extract spreads
4) Treating a baby who does not have thrush for Candida
Mothers with nipple yeast infections often ask if they should treat a baby who does not have thrush. If a mother has a nipple yeast infection, it is very likely that the baby has Candida in the mouth and the mother continues to have it on her breasts.
The treatments for nipple yeast infection don’t eliminate yeast; they just stop the problem, which is the invasion of the skin of the areola.
We do not recommend treating the baby in this situation because:
- Treatment of the baby’s mouth with antifungals will likely not eliminate Candida from the baby’s mouth or from the mother’s breast milk or skin.
- Even if Candida were eliminated, it can be re-acquired from the individual’s environment (Moossavi 2020).
- There is no evidence that mothers will have less recurrence of nipple yeast infection.
- We want to avoid treating a healthy baby with antifungal medication.
In our clinic, we would only consider treating a healthy baby if the mother had at least two episodes of nipple yeast infection and all other possible causes had been addressed. We have only had to resort to this a few times.
However, if the baby has thrush and the mother is at an increased risk of nipple yeast infection, it is reasonable to treat the mother's nipples and areolas with an antifungal cream for ten days while the baby is treated.
5) Throwing out expressed breast milk
There is no need to throw out breast milk that was expressed before treatment for nipple yeast infection was started.