Thrush - Questions and Answers

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Thrush

I have thrush on my nipples. What is it and how can I get rid of it? Will it hurt my baby?

Symptoms

Thrush is a fungal infection which can cause a problem in the nipples and breasts of breastfeeding women. It is associated with pain in both the nipples and the breasts.

Sometimes when a woman has a course of antibiotics this makes conditions easier for the thrush organisms already present in the body to increase in numbers and cause infection. Nipple damage can also be associated with a subsequent thrush infection.

The most common symptom of thrush is the pain which is distinctive. Women describe a burning, stinging or itching on and around the nipples. The pain also continues when the breastfeed is finished in many cases. Nipples are tender to touch and breasts often ache. Pain in the breast due to thrush has been described as a stabbing or shooting pain which radiates through the breast and sometimes into the back.

Thrush generally has to be diagnosed and treated by clinical symptoms only as it is difficult to obtain a positive breastmilk culture for thrush. This may be because breastmilk has some antifungal properties. Nipples may not show any signs of thrush but sometimes they may appear reddened or shiny and very occasionally a white rash may be seen.

The baby may or may not have signs of a thrush infection in her/his mouth or on the bottom. Thrush in the mouth looks like a thick white coating on the tongue and sometimes white spots are seen inside the cheeks. Thrush on the bottom can look very sore with a bright red rash and spots.

Treatment

Treatment of thrush needs to involve both the baby and the mother to ensure that one does not re-infect the other. Antifungal oral liquids such as Nystatin are used for the baby with cream for the bottom. Mothers generally use a topical treatment also on their nipples but for many women thrush does not clear until they have taken a systemic course of antifungal treatment. These medications may be prescribed only by a doctor.

There are also other ways of treating thrush. There are a number of references to Gentian Violet on the internet. Dr Jack Newman uses this successfully for both mothers and babies. If Gentian Violet is used it is important to note that only the solution of 0.5% is appropriate.

See more information on Dr Newman’s Gentian Violet protocol and further information about thrush on the Kellymom.com website - Using Gentian Violet

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Where to get help

Midwives

Healthline - 0800 611 116

Well Child

La Leche League

More information on these and other breastfeeding help providers...

Page last reviewed: 31 July 2008