Thrush is a fungal infection (candida albicans) which thrives on broken skin and in warm, moist conditions. It can be passed between mother and baby, and can often be triggered by antibiotic use in mother or baby. It can also occur after damage to the nipple.
You may have thrush if you experience:
- a sudden start of breast and/or nipple pain after days or weeks of pain-free breastfeeding – the nipple may also be itchy or super-sensitive
- shooting pains in the breast after feeding
- cracked nipples which don’t heal
- nipples which are unusually red or pale, shiny or flaky in appearance
- pain in both breasts (except in the very early stages) because the baby transfers the infection
Your baby may:
- have a white coating on his tongue, gums, and inner cheeks which doesn’t rub off
- seem unhappy or uncomfortable feeding (this may be because the baby’s mouth is sore)
- have more wind than usual and be difficult to settle
- have nappy rash which is difficult to heal
Either mother or baby may have thrush without showing any symptoms; however, both will always need to be treated to solve the problem.
Other possible causes
It’s easy to confuse the symptoms of thrush with other problems. Make sure painful feeding isn’t caused by poor attachment by asking your midwife, health visitor or breastfeeding counsellor to watch you feeding. Other possible causes of pain include eczema, tongue-tie in the baby, white spot or bleb, and bacterial infection (this may be present at the same time as thrush).
Thrush will need anti-fungal treatment prescribed by your doctor. Both you and your baby will need treatment at the same time. This will usually involve a cream for you to apply to your nipples and a gel to apply to the baby’s mouth. If you have pain deep within your breasts which goes on for a long time, you may need a different medication which is taken orally. Pain generally begins to ease after three days. If you also have vaginal thrush, your partner should be treated as well.
At the same time, you will need to take a number of self-help measures.
- If you have expressed milk and stored it while you or your baby had thrush, throw it away. It could cause re-infection.
- If your baby is also sucking on a dummy, bottle teat, nipple shield or plastic toys, make sure these are carefully washed and sterilised (boiling for 20 minutes is a good method).
- Thrush spores can survive the low temperature cycles used in most modern washing machines. Put your bras through a very hot or boil wash if possible and avoid breast pads. Use a separate towel for each member of the family to avoid cross-infection.
- Acidophilus capsules can help restore the body's normal bacteria which help to keep thrush under control (these are destroyed by antibiotics, which may be why thrush is linked to antibiotic use).