What is Thrush and How Can it Impact Breastfeeding Mums?

Let’s start with the basics. What is thrush?

Thrush is a fungal infection caused by an organism called Candida Albicans. Thrush can affect the breasts and nipples and other parts of the body, as well a baby’s mouth and bottom area...

If you speak to any mother about having breast thrush she will probably describe excruciating pain during and after feeding her baby.

Thrush can be debilitating and make breastfeeding feel extremely difficult, which is why it is important to get help as soon as you suspect it so that you can be back to enjoyable, pain free feeding quickly.

Why Do We Get Thrush?

You may have gotten thrush if you have damage or cracks on your nipple, the fungal infection can more easily get inside the tissue and the ducts this way.

Thrush infections can also occur after you or your baby have had a course of antibiotics. The antibiotics may reduce the number of good bacteria in your body, allowing for thrush to flourish.

Women who are more susceptible to vaginal thrush are also more likely to get breast or nipple thrush.

Thrush is also fairly common for babies to get in their mouths. This becomes a potential risk of passing it on to you if you are breastfeeding.

How Do You Know that You May Have Thrush?

One of the common symptoms of thrush is nipple pain. For example:

• You could experience burning, itching, or stinging pain
• The pain could be mild or severe
• The pain may be made worse by wearing clothing which touches your breast
• The pain is usually still there despite any improvements made to how you attach your baby to the breast
• The nipples may feel tender to touch

Another sign of thrush could be breast pain:

• This could be stabbing, shooting, burning or described as a deep aching pain
• You may have the pain in one or both breasts

In terms of timing, often, the pain lasts throughout the feed, as well as, after the feed. In severe cases the pain could last for an hour after feeds.

What Other Signs May Appear with Thrush?

There are not always signs that exist with thrush. Some women may only describe the symptoms above, while others will have signs and symptoms. Here are a few signs to keep an eye out for:

• The nipples may be bright pink
• The areola may be bright pink or darkened, dry or flaky
• Rarely, there may be a white rash on the areola or breast

What Signs of Thrush Might You See in Your Baby?

Here are a few things to look for in your baby:

• Thick white patches or coating may be seen on your baby’s tongue
• White spots on your baby’s cheeks
• These white patches, glossy area or spots will not able to be rubbed off
• A bright red rash with spots around it on your baby’s bottom area which does not clear with usual nappy rash creams
• Your baby may have none, one or all of these signs. Remember: if there are no signs in your baby, it should not be assumed that you don’t have thrush.

How is Thrush Treated?

If you or your baby have been diagnosed with thrush you will both need to be treated.

Here’s how mum may be treated:

• An antifungal cream or gel will be prescribed for you. Sometimes your doctor will prescribe antifungal tablets for you as well in order to clear the infection.
• Apply the antifungal cream as directed. Usually you will be advised to spread the cream thinly around your nipples after feeds. Make sure to wash your hands thoroughly before and afterwards.

Here’s how baby may be treated:

• Your baby will be prescribed an antifungal gel or drops for their mouth and antifungal cream for their bottom.

Extra Helpful Tips with Regards to Thrush

Hygiene is key to prevent thrush being passed around the family!

If anyone else in the family has thrush make sure that is treated correctly and thoroughly.

Make sure you wash your hands before and after applying any medicines to your breasts and nipples and of course whenever you apply baby’s medicine as well.

Ensure you wash your hands very well after every nappy change.

Frequently change wet breast pads for new dry ones, to keep your nipples as dry as possible. Thrush likes to grow in moist, warm environments.

Only use your own bath towel; do not share with anyone else.

Wash your bras, towels and any cloth nursing pads on a high heat wash and ideally air-dry outside.

If you are using teats or soothers make sure you wash and then boil clean them after each use.

Anecdotally, some mums find acidophilus probiotic capsules help to restore bacteria which can keep thrush under control.

Some mums also find that reducing the level of sugar and yeast in their diet can be helpful.

You should start to notice an improvement within a few of days but it may take longer for the infection to be completely gone. If you see no improvement after 7 days, see your GP again and/or lactation specialist.

Unfortunately, thrush can sometimes be either over or under-diagnosed. Some of the symptoms associated with thrush could actually be other issues instead, which is why it is important to always be evaluated by a qualified breastfeeding health professional in addition to your GP.

Other Issues Which Can Cause Similar Nipple Pain

Here are a few additional causes of nipple pain that should keep an eye out for. A medical professional can help you to find out exactly what you are dealing with.

• Poor latch or attachment at the breast
• Vasospasm
• Tongue Tie
• Maternal positioning
• Bacterial infection
• Eczema on the nipple
• Psoriasis on the nipple
• Damage from incorrect pumping/expressing
• Sucking issues in baby
• White spot/bleb

The Importance of Getting Lactation Support

It is really important that if you suspect thrush or are having any other problem with pain during breastfeeding that a you seek help from an appropriately qualified health professional trained in breastfeeding and lactation issues; midwife, maternal child health nurse or lactation consultant.

How would you describe your breastfeeding journey so far? What breastfeeding questions do you have for us? Let’s have a chat here or on the Medela Australia Facebook page.