Breast & nipple thrush

Breast and nipple thrush can cause strong pain in the nipple and breast. The pain may be severe enough to lead to early weaning if the condition is not appropriately treated.

Thrush is a fungal infection caused by the organism Candida albicans, which can occur in the nipples or breast tissue (as well as other places in the body). 

If you have nipple pain that doesn’t go away when you adjust your attachment, you may need to talk with a lactation consultant or other health care professional. Early diagnosis and treatment of nipple and breast thrush will help to improve your breastfeeding experience.


Breast and nipple thrush is most commonly linked to a history of vaginal thrush, recent use of antibiotics or nipple damage.


The most common symptom is nipple pain or breast pain, or both.

Nipple thrush pain is often described as burning, itching, or stinging and may be mild to severe. The pain is usually ongoing and doesn’t go away with improved positioning and attachment of your baby to the breast. Your nipples may be tender to touch and even light clothing can cause pain.

Breast thrush pain can vary. It has been described as a stabbing or shooting pain, a deep ache or a burning sensation that radiates through the breast. It may be in one or both breasts.

It is characteristic for this pain to be experienced immediately after as well as in between feeds.

Signs of nipple and breast thrush

There are usually no obvious signs of thrush on your nipples. However some signs may be present and include:

  • the nipples may appear bright pink; the areola may be reddened, dry or flaky. Rarely a fine white rash may be seen
  • nipple damage (e.g. a crack) which is slow to heal
  • signs of thrush may be present in your baby's mouth and or on your baby's bottom or both. Thrush in the mouth appears as a thick white coating on the tongue and or white spots on the inside of the cheeks. Thrush on the baby's bottom appears as a bright red rash with spots around it which does not clear without anti-fungal treatment.

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

Management and treatment

The most common treatment for breast or nipple thrush is antifungal medication. But you also need to treat thrush in your baby and any other fungal infection in you or your family members.

  • Thrush in your baby’s mouth is best treated using an oral gel. It is important to apply the oral gel correctly. A spoon is provided to measure the dose. Do not put the spoon inside the baby’s mouth.  Use a clean finger to apply small amounts of gel at a time to the inside of your baby's cheeks and over the tongue. Apply the gel four times a day, after feeds, for one week. Then once a day for a further one to two weeks.
  • Treat any other site of fungal infection in the whole family, i.e. vagina, nappy rash, feet.
  • Keep your nipples dry by frequently changing breast pads as thrush thrives in a moist and warm environment.
  • Once or twice a day rinse your nipples with a solution of sodium bicarbonate – one teaspoon of sodium bicarbonate diluted in one cup of water.
  • Clean teats and dummies thoroughly after use and boil for 5 minutes. Replace weekly if possible.
  • To prevent the spread of thrush, wash your hands thoroughly after nappy changes and before and after applying any creams/lotions.
  • Wash towels, bras, cloth nursing pads etc in hot soapy water and air dry outside.

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