- Catch it right away. After dozens of times around this block, I can finally recognize the early signs: shooting pain in the breast - it may or may not be associated with feeding or pumping, but it's shooting pain. This is the time to start treatment. Don't wait until your nipples are cracked and bleeding, or until you have a pink yest ring and your baby has white on his cheeks. It's a lot harder to get rid of once it's established.
- Sterilize things that touch your breast. Yeast loves plastic. Sterilize your pump and your bottles regularly. If you have thrush, do this every single time they're used. If not, once every 7-8 uses is probably enough. Buy the bags to sterilize your equipment in the microwave if you're pressed for time -- they're made by Madela, and our local Target carries them. (If you're using plastic nursing pads, stop.)
- Take probiotics (acidolphilis). Not only will they help yours and baby's digestion, they actually eat the yeast in your body. Baby can take them too -- just put a little probiotic powder on your finger and have him suck it off before nursing. If you don't mind being really sticky, sprinkle probiotic powder on your nipples after nursing.
- Rinse your nipples. At the first signs of thrush, start rinsing your nipples with apple-cider vinegar after nursing (not white vinegar, that will feed the thrush). Yeah, it's stinky. The smell goes away once they dry. If it stings, you know you really need it. When thrush is a bit more established, you can try rinsing with diluted tea tree oil (a few drops in 1/4 cup of water. Stronger if your nipples will tolerate it), or with diluted grapefruit seed extract (one drop in 1/4 cup of water). Tea tree oil is about the best anti-yeast substance around, but it'll dry out your skin, so use it carefully.
- Skip the sweets. Yeast eats the sugar that we eat, and grows by leaps and bounds when we eat sugar. Starve it out by skipping anything sweet. If you're really having troubles, skip just about anything white -- white flour, all sugars, and starches and sweetened drinks. As a side benefit, you'll lose weight. But you might go insane without the sugar. We're more addicted than we realize.
- Genetian Voilet. I haven't really had much luck with genetian violet, to be honest. But it's highly recommended around here, and I know it's helped some of my friends. Spread it on your nipple just before nursing, and let baby turn purple too. Be careful, it'll stain everything.
- Garlic. It's good for practically everything. If you can get a nice juicy clove of garlic, and just spread the juice right from the clove onto your nipple, that's terrific. If you can't, press the garlic and spread it on. Or just eat a bunch of it. My MIL inserts a cut-open clove of garlic "down there" for her vaginal yeast infections (she "sews" a piece of dental floss through it, so she can pull it back out later), and claims that nothing works better. I've had good success taking garlic capsules too -- the soft-gels seem to do the trick without making you stink quite so bad.
- Get relief. When it really gets bad, putting plain yogurt on your nipples after nursing feels really good. And it helps kill the yeast, as long as you are using it unsweetened! Another helpful relief is to buy lotrimin (you know, the cream for vaginal yeast infections, jock itch or athlete's foot). It's safe to spread on your nipples after nursing, feels good, and really helps kill that stuff off. It's not very natural, but I thought it worth mentioning here anyway. Skip creams and gels that are for relieving sore nipples. Yeast likes most of them.
- Wear cotton. Yeast likes moist, warm and dark. You can't really help the "warm", I don't think. But keep your breasts out in the open when possible (maybe sleep without a bra) and keep them dry. The most breathable bras are cotton -- it's worth the investment to have at least one cotton nursing bra. Hang it out to dry in the sunlight to kill yeast, or boil it every once in a while. (Personally, I find that my bras are fine when they're just good and dry, but technically only sunlight or high heat kills yeast in clothing).
Am I missing anything?