Why can nipple thrush make breastfeeding painful?

Thrush can inflame the nipple and areola, causing burning, stinging, or shooting pain during or after a feed. The skin may look shiny, flaky, cracked, or unusually red, although visible changes are not always present. A baby may have white patches in the mouth, but this is not required for a parent to have nipple symptoms. Other problems, such as shallow attachment, blocked ducts, eczema, or bacterial infection, can cause similar pain.

Arrange an assessment if pain continues or is worsening so feeding position, nipple appearance, and the baby’s mouth can be checked. Keep nipples clean and dry, change breast pads when damp, and wash hands before and after feeds. Continue breastfeeding or expressing if it is manageable unless a clinician advises otherwise. Parent and baby may both need assessment or treatment to prevent symptoms passing back and forth.

Seek prompt care for fever, a hot or swollen area of the breast, rapidly worsening redness, pus, a painful lump, or feeling acutely unwell. These features can suggest mastitis or another infection that needs timely treatment. Get help sooner if pain stops you feeding or expressing milk.

Ask whether the nipple and baby’s mouth should be examined, whether another cause of pain is possible, how to protect feeding while symptoms settle, and whether both of you need treatment.