What is nipple thrush and how is it treated?

Often, nipple thrush develops when a breastfeeding baby already has

. Vigorous breastfeeding can cause a break in the nipple surface, allowing Candida from the baby’s mouth to pass into the nipple.

What does nipple thrush look like?

Look out for these signs and symptoms of nipple thrush:

• itchy and flaky skin on or around the nipples
• red or cracked nipples
• pale or white areas on the nipples
• shiny skin on or around the nipples
• nipple or breast pain after breastfeeding, but no pain before
• severe breast pain that can last for up to an hour after every feeding
• burning sensation in the nipples

It’s also worth checking if your baby has symptoms that may suggest oral thrush, such as:

• raised, cream-coloured patches or spots inside the mouth – if you gently wipe these patches, they won’t come off
• white film on the lips
• redness and cracking at the corners of the mouth
• nappy rash that doesn’t clear up

When to see a doctor

If you or your breastfeeding baby have any symptoms of thrush, you’ll need to see your doctor or health practitioner to get treatment. They can review your symptoms and arrange tests like swabs from you and the baby if needed. While it is possible for thrush to get better itself, it’s highly contagious and sometimes the only way to break the cycle of infection is to get proper treatment.

If you are experiencing any kind of unusual

or symptoms, with or without other nipple thrush symptoms, speak to your doctor.

Who is at risk of getting nipple thrush?

If you’re breastfeeding, you’re more likely to develop nipple thrush. You may also be more likely to get it if you:

• already have a
  vaginal yeast infection
• have a weakened immune system
• are taking antibiotics, corticosteroids or certain drugs for cancer
• have high blood sugar levels (which may be caused by
  diabetes
  , for example)

How is nipple thrush treated?

Nipple thrush is often treated with an antifungal cream that is applied around the area of infection after breastfeeding. It’s important to wash your hands after applying any cream, to prevent the spread of the infection. Your doctor may also prescribe antifungal tablets.

You should see an improvement within 2 to 3 days, but the infection will take a while to clear completely so be sure to follow the advice of your doctor and pharmacist.

While nipple thrush is contagious, it doesn’t mean you need to stop breastfeeding. Babies with oral thrush will be treated with an antifungal gel that needs to be applied to the affected area, or with an oral rinse in older children.

How can I avoid getting nipple thrush?

Because of the highly contagious nature of thrush, it’s easy for a nipple thrush infection to return. You can avoid this by:

• getting rid of any breast milk pumped before and during treatment
• washing your hands often, especially after touching areas that may be affected
• sterilising the things your baby touches
• washing all towels, clothes and anything that comes into contact with the infected area
• keeping your nipples dry between feedings
• avoiding too much sugar and eating a
  balanced diet
• upping your
  ‘good’ bacteria
  levels by eating plenty of yoghurt or taking a probiotic supplement
• reducing stress as much as possible

Key points

• nipple thrush is infection of the nipple or breast caused by the Candida fungus
• nipple thrush usually happens if the nipples are damaged from breastfeeding
• nipple thrush is often treated with an antifungal cream and usually clears up within a few days
• you can still breastfeed with nipple thrush and during treatment