Nipple thrush while breastfeeding

Possible symptoms include burning or stabbing nipple pain during or after feeds, itching, shiny or flaky nipple skin, and breast pain that seems deeper than the skin. Your baby may have white patches in the mouth that do not wipe away easily, or a nappy-area rash, but a baby can have no obvious signs. Cracked nipples, blocked ducts, eczema, bacterial infection, and shallow attachment can cause similar pain.

Because the symptoms overlap, nipple colour or pain alone cannot confirm thrush. A clinician or lactation professional can assess the nipple, breast, feeding position, and the baby’s mouth.

Continue breastfeeding or expressing if it is manageable; stopping suddenly can worsen breast fullness. Wash hands before and after feeds, change breast pads when damp, and wash pump parts according to the manufacturer’s instructions. Keep nipples dry between feeds and avoid harsh soaps. Do not use an antifungal medicine on yourself or your baby without advice, because treatment may need to involve both of you and must suit breastfeeding.

Arrange an appointment when pain persists, feeds become difficult, or symptoms recur after treatment. Seek prompt care for a hot, swollen, very tender area of the breast, fever, chills, pus, or feeling unwell, which can indicate mastitis or another infection. Get help urgently if your baby is feeding poorly, has fewer wet nappies, or seems unusually sleepy.

Ask whether the symptoms fit thrush or another cause, whether your baby needs examination, and how to use any prescribed treatment safely while breastfeeding. Discuss latch, pumping equipment, cracked skin, recent antibiotics, and ways to prevent reinfection.