Feeding baby thrush

Breastfeeding and thrush - NHS

Breast and nipple pain in breastfeeding women is sometimes caused by a thrush (candida) infection in the breast. Breastfed babies can also develop thrush in their mouths.

Thrush infections sometimes happen when your nipples become cracked or damaged. This means the candida fungus that causes thrush can get into your nipple or breast.

Thrush infections can also happen after you or your baby has had a course of antibiotics. Antibiotics may reduce the number of helpful bacteria in the body and allow the candida fungus that causes thrush to flourish.

Signs of thrush in breastfeeding women

You may have a thrush infection in your breasts if:

you start to feel pain in both nipples or breasts after feeds, having previously had no pain after feeding
the pain can range from sore to severe and lasts for up to an hour after every feed

It's not likely to be thrush if:

you have always experienced pain while breastfeeding
the pain only affects 1 nipple or breast
you have a fever
there is a warm, red patch on 1 of your breasts

Symptoms of oral thrush in breastfed babies

Signs to look for include:

creamy white spots or patches on the tongue, gums, roof of the mouth or insides of the cheeks – if you gently wipe these patches with a clean cloth, they won't come off
your baby being unsettled when feeding
a white film on the lips
in some babies, nappy rash that won't clear up

If you suspect you or your baby has a thrush infection, see your health visitor or GP. They can arrange for swabs to be taken from your nipples and your baby's mouth to see if thrush is present. It's important other causes of breast pain are ruled out before you start treatment for thrush.

If no thrush is present, the pain may be caused by something else, such as poor positioning and attachment. It's important for your midwife, health visitor or a breastfeeding specialist to watch you do a full breastfeed and give advice if needed.

Read more about other possible causes of breast pain.

If either you or your baby does have thrush, you'll need to be treated at the same time as the infection can easily spread between you. It can also spread to other members of the family.

Washing your hands carefully after nappy changes and using separate towels will help prevent the infection spreading. You'll also need to wash and sterilise any dummies, teats or toys your baby puts in their mouth.

You'll need to wash any breastfeeding bras at a high temperature and change your breast pads frequently while you're both being treated.

If you express any breast milk while you have thrush, you'll need to give the milk to your baby while you're still having treatment. Do not freeze it and use it at a later date, as this could cause the thrush to come back.

Treating thrush when you're breastfeeding

You can carry on breastfeeding while you and your baby are treated for thrush.

Oral thrush in babies is usually treated with an antifungal gel or liquid. This is safe for your baby to have. It's important to wash your hands carefully after treating your baby.

See more about treating oral thrush in babies.

Thrush in breastfeeding women is usually treated with a cream that you sparingly spread on and around your nipples after feeds. You'll need to wash your hands thoroughly after treating yourself. Some women may need to take antifungal tablets to clear the infection.

Once you and your baby start treatment, your symptoms should improve within 2 to 3 days. It will take a little longer for the infection to clear completely.

If you don't see any improvement within 5 days, speak to your health visitor or GP.

Page last reviewed: 2 September 2022
Next review due: 2 September 2025

Thrush | Feeding Your Baby

There may be times when breastfeeding is challenging. Never ignore any issues you may have – talk to your health visitor, midwife, GP or breastfeeding specialist as soon as possible, they will be able to help you sort it out quickly.

Here are some common breastfeeding issues, and tips on what to do.

Colic
Constipation
Mastitis
Milk supply
Reflux
Sore nipples
Thrush
Tongue-tie

Thrush

If you are breastfeeding and experiencing horrible sharp, shooting pains in both breasts, this could be caused by thrush. It can make breastfeeding very painful, but don't worry – it's easily treated.

What causes thrush?

Thrush is a fungal infection in the breasts. It's easily spread, and if you are breastfeeding, you and your baby can pass it back and forth to each other. The fungus (candida albicans) is a normal part of our bodies, we all carry it, but usually good bacteria keeps it under control. The perfect environment for thrush to grow and spread is somewhere warm and moist – breastfeeding creates this perfect environment.

Check your breastfeeding position

It's worth remembering that a thrush infection may not be the cause of nipple pain, it could be that your baby simply is not positioned (latching on) properly. If you think this could be the case, ask your health visitor or lactation specialist for guidance.

Stop thrush spreading

Thrush spreads easily (and can spread to other members of the family) so you'll need to be extra careful with hygiene.

Things you, and everyone else in your household should do:

wash hands thoroughly, especially after nappy changes
use separate towels
wash and sterilise dummies, teats, and any toys your baby may put in their mouth
change your breast pads often
wash all towels, baby clothes, and bras (anything that comes into contact with the infected area) at a high temperature to kill off the fungus

If you are breastfeeding and have the following symptoms, it may be thrush. Make an appointment with your doctor as soon as possible.

If you have thrush, you may experience the following symptoms:

pain in your nipples (burning, sharp, shooting pains) that can last up to an hour after feeds
sore, cracked nipples
shiny, red or pink nipples
itchy or flaky nipples

creamy, white spots on the tongue, gums, on the inside of the cheeks or roof of the mouth (if you gently try to wipe the spots with a clean cloth, they won't come off)
there may be a white gloss on your baby's tongue or lips
your baby might feed for shorter periods, or seem unsettled during and between feeds

If you think your baby has thrush, make an appointment with your GP as soon as possible. Read more about oral thrush in babies.

Breastfeeding Friend from Start for Life

The Breastfeeding Friend, a digital tool from Start for Life, has lots of useful information and expert advice to share with you – and because it's a digital tool, you can access it 24 / 7.

Treatment

It is really important to get treatment for thrush, otherwise it may come back. Your doctor may want to take swabs from your nipple and your baby's mouth. If it is a thrush infection, you may be prescribed an antifungal cream or tablets. The cream needs to be applied to your nipples after every feed. If your baby has thrush, your doctor will prescribe a gel or cream to apply to the infected area.

Can I breastfeed if I have thrush?

Yes, carry on breastfeeding if you can. If you can't because it's too painful, try expressing your milk instead. You can give your baby freshly expressed milk, but throw away any leftovers – and don't freeze it, freezing does not kill off the thrush and you could re-infect your baby. If you are in the early days of breastfeeding, it's very important to continue breastfeeding, or expressing your milk. By pausing, or taking a break, you'll reduce the amount of breast milk you produce.

Read more about thrush and breastfeeding.

What to do if the child does not eat well because of thrush in the mouth

— Tatyana Nikolaevna, what is candidiasis in the child's mouth?

- Candidiasis in an infant is a fungal disease of the oral cavity caused by yeast-like fungi of the genus Candida (candida). Of all age groups of children in infants, it occurs most often.

— How is thrush transmitted from mother to child?

- Candida fungi enter the baby's body when passing through the birth canal, from the nipple of the mammary gland or from the hands of the mother and staff. True, several cases of infection of a child with thrush in the womb due to a violation of the integrity of the membranes have been described. Unfortunately, the intrauterine process leads to stillbirth or miscarriage.

Candida in single quantities is a normal inhabitant of the microflora of the skin and mucous membranes, including the oral mucosa. But with active reproduction, it causes a disease that in newborns and infants up to a year is due to the immaturity of the immune system.

— Why candidiasis often affects the oral mucosa in children?

— Candida fungi are well attached to the epithelium of the oral and vaginal mucosa, so candidiasis occurs more often on these organs. The most common fungal infections in young children are oral candidiasis and skin candidiasis in the diaper area and skin folds (diaper rash).

— How is thrush in children related to intestinal infections and acute respiratory infections?

- You can talk about oral thrush after taking antibiotics - this is a risk factor for the onset of the disease, but not a necessary condition.

- Can formula or breast milk cause thrush in the mouth of a newborn?

— According to statistics, bottle-fed babies suffer from thrush more often than breast-fed babies. Perhaps this is due to the fact that breast milk contains substances that inhibit the reproduction of the fungus.

The fungus can enter the child's body from the mother's breast. Therefore, laboratory detection of fungal cells in breast milk or breast milk culture is pointless, this will not affect either the treatment tactics or the outcome of the disease. But the mother needs to be checked for nipple candidiasis with hepatitis B and, if necessary, undergo external treatment, since the presence of nipple skin candidiasis increases the risk of oral candidiasis in a child.

Read also

why a baby may cry while breastfeeding and how to help him.

— What does thrush look like in the mouth of children?

- Outwardly, these are white or whitish-yellow plaques against the background of red oral mucosa. Plaques can be easily removed with a spatula or spoon, and, possibly, the mucous membrane will bleed under them. Inflammation can cause a lot of inconvenience, so often a child with thrush does not eat well.

Locations of infectious process:

tongue;
cheeks;
palate.

Behavioral symptoms of thrush in newborns:

moodiness;
decreased appetite;
food refusal.

No dangerous symptoms. There is a mild and even asymptomatic course of candidiasis, when the plaques in the child's mouth do not bother.

- Do carbohydrates (sweet) really speed up the process of reproduction of the fungus?

- Candida belongs to the Saccharomyces family. Saccharomycetes are yeasts that use carbohydrates in their metabolism. And if we talk about sweet food, then it is necessary to know whether a person has diabetes mellitus or not - this is another risk factor for thrush. And if a person has constant relapses of candidiasis, diabetes mellitus must be ruled out.

— Should a nursing mother give up sweets if her child has candidiasis?

- Warm, soft foods are more comfortable for a baby with thrush in their mouth. If a nursing mother is diabetic, but her blood sugar levels are normal on maintenance therapy, she can eat as she ate. With uncontrolled diabetes, you need to follow a diet - these issues are resolved with an endocrinologist.

— What should I do if my baby has thrush? Why is thrush dangerous?

— Present symptoms are treated so that the child is not bothered by anything. If rashes in the mouth do not cause discomfort, then thrush can not be treated. This is a transitory state, it will go away on its own. The immune system will cope with the reproduction of the fungus, provided that the baby does not have other diseases.

If a child with oral candidiasis has conditions associated with a poor immune system (congenital immunodeficiency), the infection may spread to other parts of the gastrointestinal tract. Such a child must be treated in order not to miss invasive candidiasis, when fungi appear not only on the surface, mucous membranes, but also in the internal organs.

— How to treat thrush in the mouth in children? Should mom be treated for thrush too?

- Thrush is caused by fungi, antibiotics do not work on them, so antibiotic therapy is not carried out. With thrush, an antifungal agent is applied to the oral mucosa, which the doctor will prescribe. The average course duration is 2 weeks.

A mother without symptoms does not need treatment. But if there is pain in the chest during feeding, discomfort, redness of the nipple, you need to see a doctor. If necessary, he will prescribe treatment for breast and nipple thrush.

— What should I do if my child does not get thrush even after treatment?

— If the symptoms persist, contact your pediatrician again. The prescribed drug may not work if thrush is caused not by Candida albicans (the most common cause), but by other types of fungus - Candida non-albicans. In this situation, you need to perform microscopy or seeding for fungi of the genus Candida to find out which specific type of fungus caused the disease. Based on the results of the study, the doctor will prescribe another drug.

Second option: the symptoms were cured, but there was a relapse. If at the same time the child is taking antibiotics to treat some other disease, then the cause of recurrent candidiasis is clear, and it should be treated as usual. In parallel, exclude immunodeficiencies, diabetes mellitus.

- Is immunity to the fungus developed if the child had thrush at an early age?

- Since thrush is caused by the Candida fungus, which is considered a normal inhabitant of the body, it cannot be completely eliminated. Immunity allows only to restrain the active reproduction of the fungus. But even if during the life the thrush returns, it responds well and quickly to treatment. It is not necessary to give the child prophylactic antimycotics.

Thrush in the mouth occurs in 2-5% of newborns. This is a transient condition that is associated with the immaturity of the immune system during infancy. And the main task of parents is not to ignore the external and behavioral symptoms of the disease, and if a plaque is found in the baby's oral cavity in the form of white plaques, contact a pediatrician for treatment. Thrush is well treated, but in order to exclude re-infection, it is important to adhere to preventive measures in parallel.

* Breast milk is the best food for babies. WHO recommends exclusive breastfeeding for the first 6 months of a child's life and continued breastfeeding after complementary foods are introduced until the age of 2 years. Before introducing new products into the baby's diet, you should consult with a specialist. The material is for informational purposes and cannot replace the advice of a healthcare professional. For feeding children from birth. The product is certified.

Treatment of thrush during breastfeeding: difficulties and features

Anxiety symptoms

Is your baby reluctant to breastfeed, turns away, cries when lugging? Does he have a white cheesy coating on his tongue? A caring loving mother would rather notice that something is wrong with her baby than pay attention to minor symptoms that begin in herself, such as:

sore nipples, change in their color;
pain during feeding, urination, sexual intercourse;
shootings in the chest;
genital discomfort, irritation;
burning, itching;
vaginal discharge, white, cheesy, with an unpleasant odor.

It is imperative to pay attention to these difficulties and take action as soon as possible - these are vivid manifestations of thrush. You can consult a pediatrician, an infectious disease specialist, a mammologist, a gynecologist, a dermatologist about this. A timely diagnosis will facilitate treatment and speed up recovery.

Thrush is unpleasant and dangerous

Bacterial vaginosis, thrush or thrush is caused by “bad” bacteria. Reduced immunity, the death of lactobacilli, damage to the mucous membrane, and the growth of pathogenic flora help them to become more active. These changes can be caused by past chronic, skin fungal diseases, drugs, violation of personal hygiene rules.

Thrush cannot be called a harmless nuisance, because if it is not properly treated, the consequences can be irreversible. These include:

infertility;
risk of preterm birth;
inflammatory diseases of the pelvic organs.

How to treat thrush

Many breastfeeding women are especially concerned about whether it is possible to breastfeed a newborn during thrush. Experts believe that there are no contraindications. Moreover, it is impossible to deprive the baby of the antibodies that he receives with mother's milk, because they protect the child from infectious diseases, help to overcome any ailments, strengthening the immune system.

To relieve sore nipples during breastfeeding, you can resort to various mechanical manipulations before taking medications. Nipples should be moistened with a few drops of milk, wipe the breast with a solution of baking soda. With severe pain, it is better to switch to feeding with expressed milk, while carefully sterilizing the breast pump, nipples, bottles, toys. Strictly follow the hygiene of the hands and chest.

The second step to alleviate the condition of the body affected by thrush is to balance your own nutrition, refuse baking from white flour, sugar, carbonated drinks, grapes, alcohol, kvass, hard cheeses. It is necessary to include pre- and probiotics, acidophilic foods, green teas in the diet.

Thrush is a disease that responds well to treatment. Of the drugs, antifungal and anti-inflammatory drugs guarantee a great effect.

It should be noted that antifungal drugs do not act on bacteria, therefore, to eliminate them, you will need to choose the appropriate medicine after passing the tests. Popular among many pharmaceutical market offerings is Gynodek ^R 3-component system, a topical vaginal gel that includes an antiseptic component, a regenerating component and a component that regulates the pH of the vagina. Decamethoxin and hyaluronic acid, which are part of the system, maintain the moisture of the vaginal mucosa, protect the microflora from infectious penetration, eliminate itching and burning, and destroy active bacteria that provoke discomfort. After using the drug, relief comes, the quality of sexual relations improves, well-being. The child also feels more comfortable.