Throughout the first few weeks of breastfeeding, your nipples may be sore or sensitive while adjusting to latching.
But if you’re still experiencing intense discomfort—or start to feel severe pain in your nipples—while breastfeeding after your baby is well-latched, these may be signs of a common breastfeeding complication known as nipple thrush.
Caused by an overgrowth of the Candida albicans fungus, nipple thrush is a yeast infection that grows and spreads in dark, warm, and moist environments.
While Candida is normally found on your skin and in your mouth, vagina, and gut, other bacteria in your body usually fights it off, preventing it from causing harm. However, under some conditions, the fungus can grow excessively, leading to infection.
In this article, I’ll review the causes and symptoms of nipple thrush. I’ll also explain how to treat the infection.
Nipple Thrush Causes
Nipple thrush can occur if you or your baby are taking antibiotics.
Antibiotics treat bacterial infections, but they can sometimes target “good” bacteria. These beneficial bacteria usually work to keep “bad” bacteria and fungi like Candida from overgrowing.
But when antibiotics reduce the number of “good” bacteria in your system, yeast can overgrow and cause infection. Recent vaginal yeast infection can also lead to nipple thrush.
Another cause of nipple thrush is cracked or damaged nipples—in these cases, it’s easier for Candida to enter the nipples and cause infection. Chronic illness, such as diabetes or HIV, may also be a risk factor for nipple thrush.
If your baby is diagnosed with oral thrush, that may be a sign of nipple thrush, as the infection can spread through skin-to-skin contact. If you and your baby have thrush, you should both be treated at the same time to help prevent passing the infection to one another.
Breastfeeding with thrush
If you have nipple thrush, you can continue breastfeeding while you’re being treated, though it may be painful if you are experiencing symptoms.
If you experience severe pain while breastfeeding, you can express milk instead by hand or by pump, as it is also safe to feed the baby your pumped milk when it’s fresh, refrigerated, or frozen.
Nipple thrush can cause the following symptoms:
- Intense nipple or breast pain that continues after your baby is well-latched
- Continued nipple pain the first few weeks of breastfeeding
- Cracked nipples
- Intense nipple pain deep in your breast while nursing or pumping, or after
- Itchy or burning nipples
- Nipples that look pink, red, shiny, or flaky
Since thrush is easily spread, you should also check for these signs of thrush in your baby:
- White spots or patches on tongue, gums, insides of cheeks, or roof of the mouth
- White film on lips
- Redness in mouth
- Bleeding from wiping sores
- Mood changes, including fussiness
- Diaper rash
- Not wanting to nurse due to soreness
Treatment & Management
Nipple thrush is commonly treated with topical antifungal cream.
Always consult your doctor about which over-the-counter treatment to use. To help alleviate pain and reduce swelling caused by nipple thrush, you can take oral pain medications such as Tylenol.
The following antifungals can be used to treat nipple thrush:
You can also treat nipple thrush with the following oral medications:
- Oral fluconazole
- Oral ketoconazole
At-home supplemental remedies
Nipple thrush needs to be treated with medication. In addition to medication, there are steps you can take at home involving hygiene and diet to help manage the infection:
- Thoroughly clean items that come in contact with the infection: Using hot water and soap, regularly clean items that touch your nipples or baby’s mouth, such as pacifiers, toys, teethers, breast pumps, and sippy cups. You can boil certain items for 20 minutes to sterilize them. You should also wash clothing and bedding that you’re in contact with (separately from other laundry), and use bleach when possible. Regularly clean surfaces that the baby comes in contact with, like diaper changing stations.
- Wash your hands: After you touch your breasts or care for your baby, wash your hands thoroughly. Everyone in your household who cares for the baby should also wash their hands.
- Wash your breasts: Rinsing your nipples with vinegar and water solution after breast feeding may also help. La Leche League International recommends 1 tablespoon of apple cider vinegar to 1 cup of water or, instead of vinegar, 1 tablespoon of baking soda to 1 cup of water.
- Keep your breasts dry: Since the fungal infection thrives in moist environments, keeping your breasts and nipples dry may help manage the infection. After rinsing your nipples, dry them with a clean towel or a hair dryer on a low setting.
- Reduce intake of sugar and yeast: Since fungus thrives on sugar, it can make the infection worse. Along with sugar, you should also cut down on cheese, bread, alcohol, and other food and drinks that contain a high amount of yeast.
- Increase intake of probiotics: Probiotics are “good” bacteria that can help fight off the overgrowth of yeast. To increase probiotic intake, you can eat certain yogurts or take probiotic supplements.
When to See a Doctor
If you see any signs of nipple thrush or thrush in your baby, call your doctor and your baby’s doctor so you can both be diagnosed. That way, if needed, you can both be treated at the same time.
If symptoms continue after two to three weeks of treatment, contact your doctor.
How K Health Can Help
If you’re experiencing nipple thrush symptoms and want to consult a medical professional, K Health can help. Did you know you can get affordable primary care with the K Health app?
Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.
Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Thrush in Newborns. (2019).
A prospective study of fluconazole treatment for breast and nipple thrush. (2011).
Breastfeeding and thrush. (2018).