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Thrush (breastfeeding)

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 2 minutes read

Thrush is caused by a fungal infection called candida, which can enter and affect the breast and nipple area in breastfeeding women. This can happen when the nipples become cracked or sore because the latch or position is incorrect. Thrush can develop after a course of antibiotics, as antibiotics can reduce the number of good bacteria that help fight infections like fungus. Thrush on the breast can also cause breastfed babies to develop thrush in their mouths.

How will I know if my baby is affected?

Both your breasts may feel painful after feeding. Breastfeeding can sometimes be painful for several reasons, but thrush-related pain is a new, severe pain that lasts for some time after feeding.  It is not usually associated with other symptoms such as fever or vomiting. 

Babies may become unsettled after feeding, and if you look inside their mouth, you may notice white spots or patches on the tongue, inner cheeks, the roof of the mouth, or gums. Unlike milk stains, thrush patches do not go away on wiping.

What will my doctor do?

Your doctor or midwife can order swabs from your nipples and your baby's mouth to confirm if there is thrush.  However, a diagnosis can often be made based on the history and examination without needing swabs. 

Your doctor will provide an antifungal cream to apply to your nipples after feeding. At the same time, the baby will be given antifungal gel or liquid drops that are safe for the baby. Symptoms should start improving within a couple of days, but if you don't notice improvement or have any other concerns, you must speak to your midwife or doctor immediately.

Is it contagious?

Yes. This is why your doctor will need to treat both you and your baby simultaneously, as the infection can pass easily between a breastfeeding mother and child, as well as anyone else in the household.

Is there anything else I can do?

Breastfeeding bras need to be washed at high temperatures, breastfeeding pads must be changed often, and good hygiene practices must be followed. This includes washing your hands after diaper changes and handling breastfeeding equipment, as well as properly sterilizing breastfeeding equipment, toys, and pacifiers between each use. Expressed milk should not be frozen for a later date but instead used immediately.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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