Thrush Infection When Breastfeeding

How to know if you or your baby has thrush. Get remedies and treatments for getting rid of a thrush infection in you and your baby, especially when breastfeeding.

Mom breastfeeding baby

If you are breastfeeding and it suddenly becomes very painful, there is a chance you have thrush.

Thrush is a fungal yeast infection.

I had thrush/yeast issues with both Kaitlyn and McKenna. Twice with McKenna. Thrush/Yeast infections are very difficult to get rid of when breastfeeding, and I know from experience they are very painful for the nursing mother.

It all started with Kaitlyn, my second child. Kaitlyn was born a perfect nurser. She had perfect form and latch and was very efficient.

There was never any pain involved with nursing her. It was such a dream to have a smooth experience!

When she was about a month old, nursing started to get a bit painful. At first,  I thought it was normal. It was very painful for me when Brayden was first nursing, so I figured it was just the normal “callousing” coming a bit late.

But it just continued to get worse.

And worse.

I started to bleed from my nipples. Oh it was painful!

I called my lactation consultant friend and she attributed it to poor latch. I accepted that.

By the time Kaitlyn was 6 or 7 weeks old, my logical brain kicked in. It didn’t make sense we would spend a month nursing pain-free, then suddenly get so bad. My LC friend thought it could be she was sucking harder now, but it just didn’t make sense to me.

Plus, it was only getting worse.

I literally curled my toes in pain every time Kaitlyn nursed. It felt like someone was stabbing me with a knife in the breast. It hurt so much worse than anything had with Brayden.

Finally, one day, I Googled ‘bleeding nipples’ and up came information on Thrush!

Yes! That was the problem!

I read about it on several sites and realized that is what I had.

I contacted my doctor and also contacted Kaitlyn’s doctor.

Went went in to get Kaitlyn examined. She had some thrush spots in her mouth behind her lips, not on her inner cheeks or tongue where I was checking.

I wish I could say that after a week of anti-fungal medication, we were both perfect. No. It wasn’t until she was 7 months old that we were finally yeast free.

Yep. 7 months old.

But we did get things so I was not in sharp, shooting pain at even the thought of nursing.

So what is thrush? And what do you do about it? Let’s dive in.

Thrush/Yeast Infection Symptoms

Thrush is yeast. It is an oral yeast infection caused by Candida albicans. Thrush isn’t serious other than it can interfere with feeding baby, even if you bottle feed.

Thrush Symptoms in Baby

In a baby, you will likely see white patches in the mouth somewhere. The biggest sign for me was that she had what appeared to be a diaper rash, but it would not go away. It had red, raised bumps all over her diaper area.

Here are some common thrush symptoms in a baby:

  • White or yellow patches in the mouth. It can be on the gums, tongue, cheeks, or roof of the mouth
  • Corners of the mouth are cracked
  • Diaper rash that won’t go away
  • Fussy baby

Note that newborns often get a white milk leftover on the tongue after feeding. If you worry that is thrush, try wiping it with a clean cloth or gauze. If it comes off, it is just milk. If it comes off but the tongue bleeds, it is likely thrush. If it doesn’t come off, it is likely thrush.

You can find images of thrush in babies here.

Thrush Symptoms in Mom

If you are breastfeeding, if one of you has thrush, the other likely does also. For me, it starts with bright red nipples. They are also very sensitive all of a sudden.

It then moves on to burning. It can burn in the nipple area and when it spreads enough, it burns in the milk duct area, so you feel it everywhere your ducts are. At this point, you will have shooting pains when you nurse your baby.

You will start to crack in your nipples. And not just a “I am a first time mom nursing a baby” crack, but a full on split down your nipple. And in my case, blood gushing forth (sorry, but true).

You might also find you have a red rash on your breast like your baby might have on the bottom.

Your breast and/or nipples might be itchy.

Let’s put them in a nice, scannable list:

  • Red nipples
  • Sore nipples
  • Itchy nipples and breast
  • Dry, flaky nipples
  • Burning in nipples and breast
  • Sharp shooting pain

Causes of Thrush Infection

Thrush is a yeast infection and comes from a very common yeast. Some babies pick it up in the birth canal as they are born.

Babies born before 37 weeks old or who have a low birth weight are at higher risk for developing an overgrowth of Candida albicans.

It is also very common if mom or baby are on antibiotics (this was our problem every time). The antibiotics kill the good bacteria that keeps the fungus in check.

This yeast thrives in warm, dark, moist areas, so it can develop in the diaper area or it can develop on your own breast if you do not change wet or damp nursing pads often enough.

You can also get it if you have diabetes, use birth control pills, or are exposed through someone in the home having an infection caused by the same yeast (vaginal yeast infection, athlete’s foot, diaper rash, or jock itch).

Thrush Infection Treatment

You can treat this! It isn’t easy to get rid of, but you can treat it.

You Both Need to Be Treated

You will need to of course see your doctor AND your baby’s doctor, even if one of you does not have symptoms.

First, you both MUST be treated at the same time.

This yeast will pass back and forth between the two of you, so if one is treated at a time, the other will develop it and then you will never get rid of it.

Some doctors will try to treat just one you, especially if only one is showing symptoms, but you both must be treated.

Be firm about this.

When Kaitlyn was a baby, her doctor told me we both had to be treated at the same time.

When McKenna was a baby and I had yeast, she had no visible symptoms. I called the office and a nurse on the phone told me she couldn’t be treated if she had no symptoms. I was finally able to get an appointment and the doctor prescribed treatment for her.

Medications

Your doctor(s) will decide what is the best course of treatment, but I do think it is wise to be aware of some options when you go.

There are several treatment options out there.

Nystatin is a common first choice in treating mom and baby. For baby, it will be drops and for mom, it will be a cream in most cases.

Some sources believe Nystatin to be rather ineffective against yeast. We personally haven’t had luck with Nystatin alone at our house.

Yeast problems often develop when the immune system is low. So if you or baby (or both in my case) were on antibiotics, then that is likely when the yeast problem developed.

Probiotics, like acidophilus, might work to help you fight the yeast, though some have found it to hurt the situation more than help.

Gentian Violet is a very popular remedy, but one I have never used. Some readers swear by grapefruit seed extract. If you decide to try this, be sure you get something well-made since baby will be ingesting it.

The only thing that has worked for me to finally rid myself of the yeast is Diflucan. And not the “wimpy” route of diflucan, but the ‘take-several-pills-day-one-then-one-to-two-pills-daily-for-ten-days’ route.

Diflucan is a pill you take by mouth. I used that and some Nystatin on the breasts.

With McKenna, I had to get a new OB (the old one had moved). She is one who doesn’t believe much in treating thrush. She thinks it will go away on its own eventually. Well, maybe so, but try telling my bleeding nipples to wait two months and it will go away. So I had to push for the Diflucan treatment, but I got it.

Also, be sure to ask for Newman’s Nipple Cream prescription if you have cracked nipples. It has to be compounded. I didn’t get that until my second round with McKenna, and let me tell you, it is fabulous. So fabulous. I can’t believe I went through two rounds of infection before this heaven-sent drug was given me.

This cream has antifungal, antibiotic, and a steriod. It treats yeast and bacteria. It is sometimes called Dr. Jack Newman’s All-Purpose Nipple Ointment (APNO).

Understand that these treatments typically take weeks to work.

Diet

Some readers commented that diet change helped them. Maybe adding more yogurt (with active cultures). Some cut dairy. Yeast likes sugars, so going low-carb and high-protein with vegetables can help.

It is always important to stay well hydrated when fighting infection.

Hygiene

There are some nipple care actions to take. One is to let the nipples dry off completely before dressing, even after nursing. You want to keep them as dry as possible.

This type of yeast is very persistent and can linger on surfaces. You need to keep things clean that come in contact with the yeast.

Wash your hands constantly. Be sure you wash after feeding baby since you probably touched your breasts in the process. Make sure you wash after diaper changes. Keep hands clean.

You might have to have a separate towel for yourself to prevent spreading it around the house.

You want to clean your breasts with water or a water/vinegar mixture after each feeding.

You can also do nipple soaks, either in saline solution or in vinegar/water mixture (1/1).

Also, keep your nursing pads dry and fresh. Be careful with the nicer disposable pads. They can hold so much liquid you might be changing them too infrequently (I know from experience).

Some people even give up on nursing pads all together while treating yeast.

You also need to clean your clothes and bras regularly to kill the yeast that will have gotten on them.

One of the harder things is cleaning everything baby comes in contact with. If your baby mouths a toy, pacifier, or bottle, it needs to be sterilized and cleaned regularly.

If you pump, you will need to thoroughly clean all pump parts, also.

Also, the sun can kill yeast, so if you can get some sun exposure on infected areas of the body, that can help.

How To Prevent and Avoid a Thrush Infection

This sound pretty awful, right? It is! So here is how you avoid it getting bad:

  1. Be aware of the signs. A big part of my problem with Kaitlyn is I didn’t realize what was going on and it got really bad before we started treatment.
  2. This often happens after a round of antibiotics. If you or your baby are or have been on them, keep a lookout for symptoms. With Brinley, I worked hard to make sure I didn’t get mastitis because that leads to antibiotics, which for me, leads to yeast problems.
  3. Let nipples air dry after showering and/or nursing.
  4. Clean with water daily (to avoid, not treat).
  5. Keep nursing pads dry and fresh. As I said above, watch those nice and absorbent pads. They hold more than you realize.
  6. Keep hands clean.
  7. Treat cracks in nipples. The APNO cream I talked about above can heal cracks and help prevent yeast from really getting a holding.

Conclusion

It is important to note that freezing does not kill yeast, so if you store pumped milk from the time you were infected, you will reintroduce it when you feed baby that milk down the road.

Thrush is very contagious, but you can still be successful with breastfeeding even if you both contract it.

Know what your options are, be an advocate for you and your baby, and be careful and persistent as you work to get rid of the infection.

You can read more about my experience with thrush with McKenna in the linked posts below.

If you have pain when breastfeeding and it doesn’t sound like thrush, read up on mastitis.

Related Posts

This post originally appeared on this blog January 2011

Thrush infection when breastfeeding

23 thoughts on “Thrush Infection When Breastfeeding”

  1. I had the SAME experience and Grapefruit Seed Extract finally kicked it in just a week after months of Nystatin on and off. You make a mixture of 10 drops of Citricidal Grapefruit Seed Extract to one ounce of water. Then with a very clean finger swab it around inside your baby's mouth a few times a day. You can also put on your nipples. Also, giving the baby probiotics can help reestablish the right balance of non-yeast bacteria in the body. We used the Neonate brand and either mixed it in breast milk or just put right in her mouth on a finger. You can also put on your nipples.

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  2. We dealt with thrush as well when my daughter was about 6 weeks old. Ours was not as extreme, so I had no rash or bleeding. The big clue for me was the burning. I knew that was not normal, and a breastfeeding book helped me determine it was thrush. Nystatin knocked it out in 2 days with my baby, who only had a small spot on her lower lip. My doc had a special ointment compounded for me, and it quickly healed me. Be sure to sterilize any pacifiers or other objects that your baby puts in her mouth, or you could end up battling yeast for quite some time. In addition to your other clothes, make sure you frequently wash your nursing bras and gowns with vinegar, since they will come in direct contact with the yeast. Change your nursing pads with every feeding.

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  3. Thank you so much for this post! I have been dealing with thrush for the past 4 weeks. On our 2nd round of trying nystatin. I am not as bad, but the yeast is still there! I am going to try some of your recommendations. Wish me luck!

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  4. My oldest one used to get thrush from her nebulizer. She was on pulmicort twice daily for three years. I heard it's pretty common to get thrush from that. And she used to get it pretty bad. Even though I nursed her for 13 months I never got it. I'm so thankful for that, especially after reading your post here. The first time she got it we were overseas and I had no idea what it was or what to do about it. Luckily a friend of mine, who lives there, is a doctor and he suggested vishy water. Just wipe with a cotton pad soaked in it. It will bleed to start with. But I was surprised at how well it worked. This is the only treatment we ever used and it helped every time. It only took a couple of days and it was gone.

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  5. Great info! Doctors are saying that yeast is becoming more and more resistant to Diflucan and Nystatin. I have used a combination of Gentian Violet (fabulous stuff!), Grapefruit Seed Extract (drops for baby, pills for me), Newman's All Purpose Nipple Ointment, and CJ's BUTTer (yeast formula) for baby. I've had yeast with every child I've nursed (I'm on #4 right now). Anywhere else on the body, I've used Tea Tree Oil with great success. I don't bother going to the doctor for treatment of yeast for me, or for baby… all of these remedies ALWAYS do the trick. The nice thing is that they're all natural (well, other than Newman's APNO), so if you suspect yeast, go ahead and start treating… it won't hurt you if it ISN'T yeast, but since it most likely is, you'll be feeling better sooner than if you have to wait for a doctor's appointment (the Gentian Violet can work in just a day or two!).

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  6. Both my son and I had a severe case of thrush that lasted for about 3 months. It was bad and I didn't even know it! Being a new mother I wasn't sure exactly what it was. I had people tell me it wasn't thrush because the baby's mouth didn't have any white patches. Obviously, they don't have to be there or they could be hiding. My nipples bled and the skin all around the nipple and areola got rashy, itchy, and eventually started peeling. The doctor started me with Nystatin and that didn't do much of anything. After a couple weeks/months I finally asked the doctor about Diflucan and he perscribed it to me. I can't remember for sure, but I may have had to go back again after the first dose. It may have come back. The thing that I remember most is that when the doctor looked at my breasts he couldn't believe that I had not come in sooner. He was shocked that I could even stand the pain! Next time I will know and hopefully nip it in the bud if it does happen again!

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  7. Both of my daughters struggled with thrush and my 13 week old just went through it again. The lactation consultant had me use Lotrimin AF on my nipples after nursing 3 times a day for 14 days. Then I can use it as a preventative in the morning and at night. I also did Nysatin for her and Diflucan for me but the Lotrimin has also helped keep it away!

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  8. I had a yeast infection too when my daughter was 4 weeks old. It seemed weird to me that just when nursing didn't KILL every time for the whole time, it was getting worse again. I found it through googling and found the white spots on her upper gums just above where her two front teeth would come in. The doctor was amazed I had found it so early, so look carefully! My doctor actually had me put athlete's foot cream on the nipples right after nursing her so that it would wear off before the next time I nursed her in addition to the other treatments.A word of warning about cloth nursing pads. I use cloth diapers during the day and when we are at home so I also had some cloth nursing pads. I don't recommend them in the first few months when they're getting wet all the time. I really think using them and having them be wet had to do with my infection. I switched to disposable pads and was changing them about 2-4 times per day. If they feel "squishy", it's time to change them for sure, just like baby's diaper!

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  9. Great post! I also had a yeast infection during the first 7 weeks of my nursing experience. My Lactation Consultant told me it was the worst case she had ever seen and I can honestly say it felt like someone was cutting my nipples with razor blades! (sorry, but true!)I also took Diflucan and they told me to use a mixture of Monistat, Polysporin and Hydrocortisone 10 cream on my nipples after each time I nursed. I also got a prescription for drops for my daughter in case she also had thrush.I also advise to sterilize the baby's pacifiers EVERY day and also wash in hot water any burp cloths, bibs, clothing that may come in contact with the baby's spitup/drool…This stuff is NO FUN at all, and I wished I hadn't waited so long to try and figure out why I was in such pain..I just thought it was normal since it was my first baby.

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  10. I have been struggling with yeast for almost two months! It's been awful! My little one only showed signs in his diaper rash area. I tried gentian violet, probiotics, garlic (used fresh in lots of meals, it's supposed to kill yeast also), vinegar wash, everything. It finally took both of us on diflucan AND gentian violet AND probiotics at the same time to get rid of it all. Ugh. If you have this, you have my complete sympathy!

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  11. For me thrush has been less obvious. He is 10 weeks and latches well but would suddenly pull off and scream. So I called my dr and told her what was going on. I thought it was acid reflux so i was surprised when she wanted to treat for thrush. The sores in his mouth were not very obvious – he just had a white coating on his tounge and that's all I could see. Also, I didn't realize I had it either because my nipples just looked slightly irritated – sort of like a sunburn or like the first couple weeks of nursing. He also didn't even have a sore bottom…until we started treatment. We are both on nystatin, an ointment for me and a syrup for him. Today we got checked because it's been over four days and he was still struggling with eating. I have been bottle feeding to make it easier on him.So – the PA I saw said he thinks it is clearing up and to continue for only 3 days because the med might be upsetting his tummy. I also talked to a lactation consultant who said to be sure to go the full two weeks or it can come back with a vengeance. She said to boil all my pumping parts in vinegar water half way through the treatment and again at the end. Also, throw all pacifiers and bottle nipples that he used away at the end and wash my bras and burp rags in an extra rinse containing a cup of white vinegar. She said vinegar is the birth control for yeast. She also said just get regular OTC yeast infection ointment for his bottom bc the yeast travels through his gi system and out his bottom. Also, use a mixture of 1 cup of water with 1 tbs vinegar and rup it on my nipples after every feeding, let air dry and then add the nystatin ointment. Also, when he is fussing after five minutes of eating switch to the other breast because he doesn't have to suck so hard to get the milk…just keep switching back and forth. So…moral of the story, if you don't know why your baby is screaming after eating 4-8 minutes check out your breasts and his mouth and consider thrush…it's very common and treatable! And when in doubt, use vinegar!

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  12. Just wanted to add that if you are having a problem with recurring clogged ducts or milk blisters, thrush is often to blame. If you know you are doing everything you can to prevent clogged ducts and are still having a problem, thrush might be the underlying cause. I went to see my OB/GYN twice in the past few weeks for this issue and she never once suggested thrush. I finally looked at a list of symptoms on kellymom.com and read this post and realized I had all the symptoms even though my son doesn't. I will definitely call the ped and have him treated as well.

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  13. I realize this is way after the fact, but I just ran across this post and really, really wish I would have run across it a couple of months ago!! We have been battling thrush since I can remember, I think it was worst at about 10 weeks or so. It got to the point I couldn't have her latch without grabbing onto something and swearing loudly… It felt like someone was stabbing my boobs with a hot poker!I think we had yeast for awhile, it just took getting to that horrible point before I finally realized that something was NOT normal. It didn't help that for the first 6-8 weeks, we were using a nipple shield (Hindsight, we definitely didn't need it that long. Screwed with my milk supply, and she took FOREVER to eat. Not to mention harboring yeast.)I've known I've had problems with yeast for a long time, but I never even knew there was such a thing as a BFing yeast infection. The internet was my friend for definitive diagnosis. We tried: 1. Nystatin cream and drops. Big surprise, it did almost nothing. Had to stop using the cream after two uses because of the perfumey crap in it, irritated my already super irritated nipples! Plus, it was hard to wash it off before nursing. Ugh, smelled like a nursing home.2. OTC clotrimazole cream and cont'd nystatin drops. Helped slightly, but the infection was way beyond this being the sole cure. Also- why exactly is nystatin suspension in a super sugary base? Seems counterintuitive.3. Gentian Violet. Felt like it worked at first, but soon yeast came back and I got tired of the stress and mess. 4. Oral Diflucan. This was interesting, since my doc refused to prescribe enough to treat me properly. It worked within a few days, but was soon back probably because of too-short treatment. She wanted to see me AGAIN in the office (had seen her twice since then, plus, taken the babe in once, didn't have time or money to waste at that point), and wanted to draw liver function tests. Unnecessary. 5. Besides the hygiene things I had done (boiling everything, washing on hot with vinegar rinse, etc.), I started ALWAYS washing off my nipples after nursing. Would then dab with a 50/50 solution of raw apple cider vinegar and water. Would let air dry, then use olive or coconut oil to soothe (also antimicrobial). The yeast is still there, but tolerable. Some days, it seems like it is pretty well gone!I stopped wearing nursing pads. I don't leak much anymore, would just stick a burp cloth or something on my non-nursing boob. I just wear a cotton nursing bra.I've also been taking probiotics the whole time. I had slacked off for awhile in my sleep-deprived haze, bad idea.The moral of this very long (sorry!) comment is that doctors don't always know how to recognize and properly treat yeast, even those with a lot of peds experience. You may have to take things into your own hands. (For recommendations on Diflucan dosing, see Hale's Medications and Mother's Milk or Briggs's Drugs in Pregnancy and Lactation if you can find access)

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  14. Sarcastic Celiac,I don't mind the long comment at all! Thanks for sharing your experience! I think it is so helpful to hear it from lots of people to get all of the ideas and experiences we can.

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  15. There is only one thing that has worked for me and it's really hard but really worth it. I have to go off all processed sugars. I literally go through withdraw symptoms (grouchy, shaky, headaches, sweats) for a couple days. I feel an improvement within a day or two and after about a week I feel great and swear off sugar for life. Unfortunately I've had thrush with four babies and every time I end up back on sugar as soon as I'm done nursing. I would love for there to be an easy fix but I've tried everything and this is the only thing that's worked for me.

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  16. Lisa,Breastmilk is full of sugar, regardless of what you eat. I learned this after doing a month of candida cleanse and still having it.

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