Breastfeeding with Thrush

Breast and nipple thrush can cause intense pain if not treated early. Lactation expert, Rebecca Agi, discusses symptoms, causes and treatment.


Are you experiencing deep, stabbing breast pain during or after feedings? Are your breasts shiny, flaky, blistered or red? Do you notice creamy white spots on the inside of your baby’s cheeks, or on the tongue, gums or lips? Or a diaper rash that over-the-counter remedies won’t resolve? Unfortunately, these are common signs of thrush. If you’ve answered, “yes” to two or more of these questions, you’ll want to contact your healthcare provider for assessment and treatment. The good news is that proper treatment can soon help get you and your tot back to painless nursing. There are just a few things you should know in advance to help treat thrush and minimize the chance of reinfection.

What Is Thrush?

Thrush is a yeast infection caused by the fungus Candida. Even though yeasts are normal inhabitants of the skin, mouth, digestive tract and vagina, sometimes there’s too much and the result is a thrush infection. These organisms thrive in warm and moist environments (like your bra) and under certain conditions they multiply excessively, causing pain, itching and irritation. Nursing mothers with thrush often experience deep nipple or breast pain, cracks in the nipple where the nipple and areola meet, and/or a blistered rash around the areola. A baby with thrush can have an infected mouth that shows creamy white patches. Feedings can be uncomfortable and challenging. Sometimes, however, there are no apparent symptoms.

How to Treat Thrush

Thrush spreads easily. The spores linger on skin and in clothing, so both you and your baby need to be treated simultaneously, even if one of you is not showing symptoms. In addition to medical treatment, proper hygiene and diet could reduce the likelihood of spreading or reintroducing the infection.

Medical Treatment

  • Oral thrush is usually treated with liquids or gels that are applied to the affected areas in the baby’s mouth. Do not put the medicine dropper in the baby’s mouth where it could pick up the infection. Instead, apply the liquid or gel with a Q-tip or disposable swab.
  • Nipple thrush is often treated with Nystatin cream though your healthcare provider might prescribe an oral antifungal medication like Diflucan (fluconazole), depending on the severity of the infection.
  • Complete the full course of medication even if symptoms resolve earlier. Certain medications need to be used for a certain length of time to fully clear an infection.

Proper Hygiene

  • Hand washing is essential for you and your baby. Be sure to use paper towels for drying and dispose them after use.
  • When applying oral liquids, gels, or creams, use disposable swabs and wash your hands before and after application.
  • Keep your bras clean and change into a fresh one every day.
  • Avoid breast pads or choose disposable ones and discard after each use.
  • Boil all pacifiers, bottles, nipples, and pump parts for 20 minutes each day.
  • If anything comes into contact with the affected area, wash it thoroughly in hot water.
  • If you have a thrush infection, do not pump and store milk for later. While it is safe to continue breastfeeding and feeding your baby your milk, Candida spores can survive being frozen and can reinfect your baby later.


Eating a balanced diet and drinking ample water is always important when fighting an infection. Studies show that consuming large amounts of refined carbohydrate can exacerbate symptoms of thrush. Limit your intake of dairy products, sugary foods, artificial sweeteners, alcohol and caffeine, if possible.

As always, discuss your symptoms with your healthcare provider before beginning any medical treatment. If thrush is suspected, your healthcare provider will select the appropriate treatment for you and your tot. With proper treatment, many mothers and babies overcome thrush and continue their breastfeeding journey.