Nipple Thrush In Breastfeeding Moms: Signs, Symptoms, and Treatment

Nipple thrush can lead to breast pain and make breastfeeding difficult. Learn what causes nipple thrush, how to know if you’re suffering from it, and how to treat it for the needed relief.

If your breasts are burning or in significant pain, and you don’t have any lumps, nipple thrush could likely be the cause. Although nipple thrush is caused by a highly contagious yeast, the good news is it's relatively easy to treat. But it won’t go away on its own without treatment. Today, we’ll cover what causes nipple thrush, how to know if you’re suffering from it, and how to treat it for the needed relief.

What is nipple thrush? What causes it?

Nipple thrush is a painful infection of the breast, caused by a yeast known as candida. This infection usually starts in babies’ mouths – where it’s known as oral thrush. Since this thrush is so contagious, it often gets passed from baby’s mouth to their breastfeeding mother’s nipple.

But why does this thrush develop in baby’s mouth in the first place?

Candida is perfectly normal for us to have in our bodies, especially in the mouth and digestive system. But problems happen if there’s too much candida buildup. And since babies’ immune systems are still developing, they’re especially vulnerable to ending up with too much candida – so much growth that their immune system can’t stop it. (Oral thrush infections are most common in babies under 6 months of age.)

This leads to an oral thrush infection, which can be transferred to you during feeding and result in nipple thrush.

Since thrush is so contagious, babies and moms will often keep reinfecting each other during feedings if the thrush isn’t treated.

When are moms most likely to develop nipple thrush?

If your nipples are cracked or damaged and baby has oral thrush, they’re much more likely to give you nipple thrush, because it’s easier for the candida yeast to end up in your nipple.

You’re also more likely to get nipple thrush if you or baby have had antibiotics recently, as these antibiotics can sometimes kill off the “good bacteria” that stops candida from overgrowing.

And if you have a yeast infection anywhere else on your body, you’re also more vulnerable to nipple thrush.

Signs and symptoms of nipple thrush

If you have two or more of these symptoms, you’re likely to have nipple thrush:

  • Itchy nipples or areolas
  • Burning nipples (this could be on and off, or long-lasting)
  • Pain in the nipples or throughout the breasts, with no lumps or tender spots
  • Stabbing or stinging pain deep in your breasts, especially during or right after nursing (could last for up to an hour after a feed)
  • Ongoing breast pain (doesn’t go away, no matter how baby is positioned or latches on)
  • Especially sharp pain behind the areolas
  • Tender nipples
  • Flaky skin on or around the nipple and areola
  • Shiny skin on or around the nipples and areolas

These symptoms usually affect both breasts. They could be concentrated in the nipple and areola area, or could cause pain throughout the breasts.

If breastfeeding has always been painful for you, or a few symptoms like these only affect one breast, you’re much less likely to have nipple thrush.

The above signs are most likely to point to nipple thrush if baby has oral thrush. So, it’s important to look for these signs of oral thrush in babies:

  • Raised white patches in the mouth that look like milk, and that bleed when they’re touched. These patches usually appear on the inner cheeks, tonsils, tongue, and gums.
  • Red, irritated, cracked, or bleeding lips
  • Red or irritated skin inside the mouth

Learn more about nipple thrush signs, symptoms, and treatment from The Maternity Mentor:

What to do if you suspect you have nipple thrush?

If you think you have nipple thrush, it’s vital to see a doctor for treatment as soon as you can. After all, since nipple thrush is extremely contagious, you and baby will likely keep passing the thrush from your nipples to baby’s mouth.

In the meantime, you can still breastfeed baby while you have nipple thrush – it’s totally safe.

But keep in mind that your breast milk, or anything it touches, could spread the candida to baby. So can anything that touches your breasts. And if baby has oral thrush, anything that touches their mouth could spread the thrush to you.

Thus, be sure to thoroughly wash and sanitize the following with hot water and soap, every time they touch baby’s mouth or your breasts:

  • Bottle nipples
  • Breast pump parts
  • Pacifiers
  • Teethers
  • Your hands
  • Your clothing, especially nursing bras
  • Towels and burp cloths
  • Nursing pads

How is nipple thrush diagnosed?

To diagnose nipple thrush, your doctor will check your breasts and ask you to share your symptoms. They might take a sample from your breasts or of your breastmilk, to test for a yeast infection. But they won’t always do this – asking about symptoms is usually the best way to diagnose thrush.

Based on your symptoms, your doctor will rule out anything else that might be causing your breast pain, to make sure nipple thrush is the cause.

Your doctor may also check on your baby’s symptoms, if oral thrush is suspected. They will gently scrape the inside of your little one’s mouth, and check the sample under a microscope.

How is nipple thrush treated?

To treat nipple thrush, your doctor will need to prescribe an antifungal medication (antifungal cream) for you to apply to your nipples. Miconazole cream is the most common. There are several different kinds of antifungal medication, so if one doesn’t work, you have plenty of options.

Another option your doctor could prescribe is an antifungal pill to swallow.

And if you’re experiencing breast pain, they may give you a pain medication as well.

Of course, if baby has oral thrush, their thrush will need to be treated as well, so they don’t reinfect you. Your doctor will prescribe a gel to apply on the inside of baby’s mouth. Be sure that you and baby each use your own treatments as long as your doctor recommends them, as baby’s gel usually won’t get absorbed by your nipples when baby feeds.

You’ll probably need to continue the treatments for 1-2 weeks.

Can you keep breastfeeding while treating nipple thrush?

You can keep breastfeeding while treating nipple thrush. But you’ll need to make sure the antifungal cream is safe for baby’s mouth, so ask your doctor. While some creams can stay on the breasts while baby sucks, you’ll need to delay feedings for a bit after applying other creams – and still others will need to be cleaned off your breasts before a feeding.

Breastfeeding may still feel painful or itchy for a few weeks while you still have the nipple thrush. It may be easier to pump your breastmilk, or to switch to quicker but more frequent feedings (focused on the less painful breast). You can also talk to a lactation consultant if you have questions or concerns.

Unfortunately, though, you’ll need to throw out any breastmilk that you pump and store while you have nipple thrush, and that baby doesn’t drink during their time with thrush. This way, you won’t reinfect baby – and yourself – later once both of your thrush has healed.

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