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 breastfeeding causes the nipples to become cracked or sore if 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 away infections like fungus. Thrush on the breast can cause breastfed babies to develop thrush in their mouths also.
Both your breasts may feel painful after feeding. Breastfeeding can at times be painful for a number of reasons, but typically 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 start to become unsettled after feeding and if you look inside their mouths you may notice white spots or patches on the tongue, on the inner cheeks, the roof of the mouth, or on the gums. Unlike milk stains, thrush patches do not go on wiping.
Your doctor or midwife can organise for swabs to be taken from both your nipples and/or your baby's mouth to confirm if there is thrush. However, a diagnosis can often be made based on the history and examination, without the need for swabs. Your doctor will provide you with 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 to have. Symptoms should start to improve within a couple of days but if you don't notice improvement or have any other concerns, it is important to speak to your midwife or doctor straight away.
Yes. This is why your doctor will need to treat both you and your baby at the same time as the infection can pass easily between a breastfeeding mother and child, as well as anyone else in the household.
Breastfeeding bras need to be washed at high temperatures, breastfeeding pads need to be changed often and good hygiene practices need to be followed. This includes washing your hands after nappy changes and handling breastfeeding equipment as well as sterilising breastfeeding equipment, toys, and dummies properly between each use. Expressed milk should not be frozen for a later date but instead used immediately.