Thrush and Breastfeeding Signs, Symptoms, and Treatment

Mother looking up information on the computer with baby. Breastfeeding and Thrush, The Yeast Infection from Candida.
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Thrush is a common breastfeeding problem. While you can take care of some breastfeeding issues on your own, this isn't one of them. Thrush is an infection, and it needs treatment.

With treatment, you and your baby will be feeling better and back to your normal breastfeeding routine in no time. But, if you let it go, thrush can lead to very damaged, cracked, and painful nipples, a nursing strike, or early weaning. The condition also can spread to other family members.

Overview

Thrush is a yeast (fungal) infection that grows and spreads in warm, moist, dark environments. It's caused by the overgrowth of a type of fungus called Candida albicans (also referred to as Monilia, candidiasis, or candidosis).

Candida is normally found on and in your body. Usually, it doesn't cause any harm because it is kept in check by the good bacteria on and in your body. However, when there's a change in the healthy balance of bacteria and yeast, Candida can grow and cause problems.

One thing that can affect the natural balance of bacteria and yeast in your body is the use of antibiotics. If you or your baby have to take an antibiotic to fight off an infection, it also can kill off some of the body's good bacteria. Then, when there is less healthy bacteria around, it leaves an opening for the yeast to grow.

You also may be prone to yeast infections if you have diabetes. Additionally, if your breasts leak milk and you use breast pads, the warm, wet pads against your skin can provide another opportunity for yeast to grow.

Signs and Symptoms

Many times, the first indication that you may have thrush is when breastfeeding becomes very painful for you, or your baby becomes fussy and refuses to breastfeed. If you notice any of the signs or symptoms of thrush listed below, or if you think that you or your baby have thrush, call your doctor and your baby's doctor right away.

  • Breast and nipple pain: Thrush can cause severe nipple pain. If you feel burning, itching, pins-and-needles, or a sharp, stabbing breast pain, or a pain deep in your breast, you might have thrush.
  • Inflammation (swelling): If your nipples and areola are swollen and very red, it could indicate a yeast infection.
  • Nipple irritation: Thrush may make your nipples look shiny or flaky, or you may see small blisters or white patches on the skin around your nipples.
  • Diaper rash: Having a fungal diaper rash is one of the symptoms of thrush. A yeast infection on your baby's bottom looks like a red, bumpy rash.
  • Irritation in your baby's mouth: If your baby has thrush in their mouth, you may not see anything. But, sometimes thrush appears as white patches in your baby's mouth or a white coating on your baby's tongue.

Breastfeeding With Thrush

If you've just been diagnosed with thrush, you might be nervous about breastfeeding. After all, it's normal to be worried and a little scared about spreading an infection to your baby.

But by the time you realize you have it, your child's already been exposed and probably has it, too. Or, it may be that your baby had it first and gave it to you. Still, what does this mean for breastfeeding?

Fortunately, you can safely continue to breastfeed if you have thrush. However, there may be a few issues that you'll have to face. Thrush in your baby's mouth may make it painful for them. Your baby also may be fussy and refuse to breastfeed.

For you, your nipples and your breasts may hurt a great deal. If you can tolerate the pain, you should continue to breastfeed. But, don't feel bad if you need to give your breasts a break while you're undergoing treatment. You can pump to maintain your breast milk supply until you feel well enough to breastfeed again.

Don't Store Expressed Milk

Even though it's OK to breastfeed or give your baby expressed milk when you have thrush, you may not want to freeze your breast milk. Candida can live in your breast milk, and even though freezing it will deactivate the yeast, it won't kill it.

The safest route is to wait until you finish taking the entire course of medication and you no longer have any symptoms before you begin collecting and freezing your breast milk again.

Treatment

Candida grows and spreads quickly so it can be hard to get rid of it. Yeast can easily spread to other family members, too. If you think you and your baby have thrush, you need to get treated together. Call your doctor and your baby's doctor so that you can get diagnosed and treated quickly. Here is some additional advice to help speed the healing process.

  • Use medications: Both you and your baby should be treated with medication if either one of you shows symptoms of thrush.
  • Wash your hands: Good hand-washing techniques prevent the spread of many infections including thrush. Wash your hands before and after you touch your breasts, after you use the bathroom, and after you change your baby's diaper.
  • Wash your breasts: Care for your breasts by keeping them clean and dry. After you breastfeed, rinse your nipples with water or a solution of vinegar (one part), and water (four parts) then let them air dry. If you can expose your bare nipples to the sun for a few minutes every day, that's also helpful.
  • Wash your baby's items: To kill the yeast, clean all the things that come in contact with your breasts and your baby's mouth. Boil or use hot, soapy water to thoroughly wash pacifiers, bottles, bottle nipples, teethers, toys, and the washable parts of your breast pump each day.
  • Change your breast pads often: If you leave wet breast pads on your breasts, they keep your breasts warm and moist. It's the perfect breeding ground for yeast, so change breast pads whenever they get wet.
  • Keep your nursing bra clean and dry: Wear a clean nursing bra every day and change it if it gets wet. Wash your bra, nursing clothes, pajamas, and bed sheets in hot water or bleach to kill the yeast.
  • Try probiotics: Probiotics are good bacteria. Ask your doctor about trying a probiotic supplement such as Lactobacillus acidophilus, or you can eat yogurt with active cultures.
  • Limit sugar in your diet: Yeast loves sugar, so if you avoid sugary foods and drinks while you're being treated for thrush, it may help you get rid of the infection more quickly.
  • Protect your breasts: Sometimes the nipple pain can be so bad that it hurts when your bra or clothes rub against your breasts. Breast shells can protect your nipples and relieve that pain while you heal.

Medications

Antifungal medications are used to treat yeast or fungal infections. Both you and your child will need to take medication, but the medicine that you'll give your child will be different than yours. If necessary, your partner and your other children also may need a prescription.

  • Nystatin cream: Nystatin cream is an antifungal medication that you apply directly to the affected area on the skin of your breasts and nipples.
  • Diflucan: Diflucan (fluconazole) is a pill that you take by mouth. Your doctor may prescribe Diflucan if you've already tried nystatin or other antifungal creams and they didn't work. They also may prescribe it if the yeast infection is inside your breasts where an antifungal cream cannot reach or you continue to get recurrent fungal infections. Treatment with Diflucan can last two weeks or more, and it is safe to breastfeed while you're taking this medication.
  • Monistat or gyne-lotrimin: If you have a vaginal yeast infection along with other signs and symptoms of thrush, you need to treat that infection while you're treating your breasts and your baby. Your doctor can prescribe an antifungal vaginal cream or suppository, or you can use one of the over-the-counter products found at your local pharmacy.
  • Nystatin oral suspension: Your baby's doctor will probably give you a prescription for a liquid form of nystatin to use inside of your baby's mouth.
  • Antifungal diaper rash creams or ointments: You may be able to use an antifungal cream or ointment such as Mycostatin (nystatin) or Lotrimin (clotrimazole) to treat a fungal diaper rash on your baby's bottom; but you should ask your baby's doctor first.
  • Gentian violet: Gentian violet is a liquid that you swab on your nipples and in your baby's mouth. It's a natural, over-the-counter treatment for thrush that you can find in natural food stores, but should not be used longer than seven days. Be sure to talk to your baby's doctor before trying this supplement.
  • APNO: Dr. Jack Newman's all-purpose nipple ointment (APNO) contains three types of medication: an antifungal, an antibiotic, and a corticosteroid. You can rub it onto your nipples to treat nipple pain, swelling, and infections from yeast or bacteria.

It's very important to use the medication exactly as prescribed and for as long as recommended. If you feel better before the course of medication is complete and stop using it, the yeast infection can come back.

How to Get Rid of Yeast

Thrush is difficult to conquer. It can take a few weeks for the medications to work and completely get rid of the yeast. Plus, yeast may be lurking in areas of your body other than your breasts and your baby's mouth. When these areas are left untreated, the yeast can show up again even after you think you've successfully treated the infection.

Yeast also can live on pacifiers and toys so it can quickly spread to your other children. When you're dealing with thrush, it may take a little work to wipe it out. Follow the medication instructions provided for both you and your baby, try to keep up with cleaning all the things that your breasts and your baby's mouth touch, and most of all, be patient.

If thrush doesn't seem to be getting better or it keeps coming back, talk to your doctor or a lactation consultant.

Other skin conditions such as psoriasis or eczema can look like thrush. Your health care provider will examine you, investigate your situation further, and reevaluate your treatment plan if thrush appears to be lingering longer than expected.

A Word From Verywell

If you suspect that thrush is the culprit for your breast pain or your baby's fussiness, it's important to talk to both your doctor and your baby's doctor. Even though thrush will sometimes clear up on its own, getting treatment is the only way to ensure you and your baby aren't getting reinfected.

Keep in mind, too, that thrush is extremely contagious and can be passed back and forth between you and your baby as well as among family members. Be sure to regularly clean your bras, clothing, sheets, and breast pads as well as use good hygiene practices. With treatment and a commitment to following your doctor's advice, you both will be feeling better in no time.

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Article Sources
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  6. La Leche League. Storing human milk.

  7. U.S. National Library of Science. Fluconazole. Updated December 15, 2018.

  8. American Academy of Pediatrics. Thrush and other Candida infections. Updated October 21, 2020.

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