Thrush is an infection caused by the fungus candida albicans.

Breast thrush presents as severe nipple and/or breast pain, often after a period of pain free breastfeeding. It can also follow cracked nipples and is more likely if the mother has received antibiotics.

Mothers report extreme levels of pain and sensitivity in the nipples and sometimes deep within the breast. The pain will continue after the feed has stopped. Other symptoms can include loss of colour, redness or flakiness of the nipple and areola area and cracked nipples which do not heal.

The baby may have white plaques in his mouth, be less keen to feed if his mouth is sore or have a sore bottom. Often however, there are no visible signs and mothers report only on the pain.

Recently there has been a tendency to over-diagnose thrush in the UK. Before commencing treatment, all mothers should have a feed observed as the most likely cause of the nipple pain is ineffective attachment. Even what appears outwardly to be good attachment can often be improved, thus relieving the pain.

FAQs

How is thrush treated?

Thrush is treated by anti-fungal medications which are prescribed by a doctor. Both mother and baby should be treated together, usually cream for the mother and drops/gel for the baby’s mouth. Deep breast pain will require systemic treatment with oral anti-fungal tablets. More information about the drug treatment, including information for both parents and health professionals can be found here.

The pain of thrush should not be underestimated and pain killers are likely to be needed. The symptoms usually start to improve within 2-3 days of treatment starting.

In addition there are a number of measures that women can use to help relieve symptoms and avoid recurrence:

  • Thrush spores can survive low temperature wash cycles so wash clothes such as bras and towels on as hot a wash as possible. Ironing can also help to kill the spores
  • The spores can also survive freezing so discarding any frozen breastmilk which was expressed during the thrush episode should help prevent re-infection
  • Careful sterilizing of any items such as dummies, teats and teething rings by boiling
  • Acidophilus capsules can help to restore the bodies own normal bacteria (which may have been destroyed by antibiotic therapy) and these help prevent the thrush spores from multiplying

More information is available at the Breastfed Babies website.

Further information to aid staff to make a diagnosis of thrush may be found here.

Further information for staff about the treatment of thrush may be found here.