Nipple thrush is a breast yeast infection that you can get when breastfeeding. It’s caused by an imbalance of bacteria, and you and your baby can pass it back and forth. Nipple thrush symptoms include red, itching, burning nipples. You and your baby will need to be treated with anti-fungal medication at the same time, but you can continue to nurse if you have thrush on your nipples.
IN THIS ARTICLE
- What is nipple thrush?
- What causes a nipple yeast infection?
- What does nipple thrush look like?
- Nipple thrush treatment
- Can I breastfeed with a nipple yeast infection?
What is nipple thrush?
Nipple thrush is a yeast infection on your nipples, and you probably got it from your breastfeeding baby.
Thrush is a common yeast infection found in the mouth, and it often shows up in babies. It’s caused by an overgrowth of a type of yeast called Candida albicans, which also causes some diaper rashes in babies and vaginal yeast infections in women.
If your baby has thrush and you’re breastfeeding, they can transfer the infection to your nipples. When the infection affects your nipples, it’s called candidiasis or a nipple yeast infection, though many people refer to it as “nipple thrush.”
Candida likes warm, moist, dark environments, and that’s exactly what your baby’s mouth and your nipples provide during nursing. If you have a yeast infection on your nipples, it’s important for you and your baby to be treated at the same time. Otherwise, you may just pass the infection back and forth.
What is thrush?
If you notice thick white patches on the inside of your baby’s mouth, it might be thrush. Learn what causes thrush and how it’s treated.
What causes a nipple yeast infection?
Having a little yeast on your body is harmless. It’s normally found on the skin and in the genital area, mouth, throat, and digestive tract. It lives alongside the “good” bacteria that help keep the amount of yeast in the body under control. When the balance of bacteria is disrupted, though, the yeast multiplies and causes a fungal infection. Sometimes thrush infections become chronic.
It can be hard to pinpoint one cause of a nipple yeast infection, but usually something tips the balance of bacteria, and/or the environment encourages the growth of Candida. Some women and babies are simply more susceptible than others.
Things that can lead to a nipple yeast infection include:
- Taking antibiotics or corticosteroids
- Taking oral contraception
- Previous nipple damage
- Exhaustion and stress
- Previous vaginal yeast infection
- Excessive sweating and moistness around your breasts
- Certain health conditions, such as anemia or diabetes
- Pregnancy and other causes of a weakened immune system
What does nipple thrush look like?
If you have nipple thrush, your nipples may be pink or red. If you have dark nipples, it may be harder to see a color change. They may be shiny and cracked, and the skin may be flaky.
(Note that pink, tender nipples can also be a sign of a bacterial infection or dermatitis, which should be diagnosed and treated by your provider or a dermatologist.)
Other nipple thrush symptoms include:
- Itching, burning, or deep, shooting breast pain during or after feedings
- White patches or tiny blisters on the nipple or areola (the area around the nipple)
- A nipple wound that won’t heal
- Having a recent vaginal yeast infection
Your provider may diagnose nipple thrush by examining your breasts and asking you about symptoms. Looking at the area is usually enough for a diagnosis, but they may also do a swab to look for the yeast under a microscope or in a culture in the lab.
It’s possible for both you and your baby to have thrush even if one of you is symptom-free. That’s why it’s important to contact your healthcare provider for diagnosis and treatment for both of you if either you or your baby have symptoms.
If your baby has thrush, you may see white patches on their cheeks, tongue, gums, or the roof of their mouth.
Nipple thrush treatment
A nipple thrush infection can become chronic and difficult to treat, but with diligence you should be able to get rid of it within a couple of weeks.
Treatment for a nipple yeast infection includes:
- Antifungal cream. Your provider may prescribe a cream or gel such as Miconzole, or they may recommend an over-the-counter antifungal cream, such as Lotrimin or Monistat. You’ll apply the cream to your nipples as directed after nursing for a week to 10 days. (At the same time, your baby will be treated with a prescription medication, which you’ll squirt in each side of their mouth.)
- Oral medication. If you’re still in pain after being treated with topical medicine, you may need a more potent oral antifungal medicine, such as oral Fluconazole. It may take a week or longer to work, and you may need to take it for at least 10 days. Be sure to finish the entire dosage, even if you feel improvement before then.
- Pain reliever. To ease any deep breast pain, you may want to take the appropriate dose of ibuprofen or acetaminophen until the worst is over and your treatment starts working.
- Probiotics. You may also want to add Lactobacillus acidophilus to your diet to recolonize your digestive tract with the bacteria that keep yeast in check. Look for yogurt containing live Lactobacillus acidophilus cultures, or take it in pill form. Ask your healthcare provider for recommendations and dosages before taking supplements.
Gentian violet is an over-the-counter liquid dye that was used in the past as a treatment for oral and nipple thrush. However, there are drawbacks: If it’s used for too long (or in a concentration that’s too high), it can cause mouth sores in infants and nipple skin irritation in nursing moms. It’s been found to be toxic in animal studies.
The treatment is also very messy to use because it stains anything it comes in contact with. Gentian violet is rarely recommended for treating thrush now, but if your provider thinks it’s appropriate for you, they can give you instructions on how to use it safely.
Here are other things to do while you’re treating your nipples for thrush, to help eliminate the infection – and possibly prevent another one:
- Keep your nipples dry. Try to keep your nipples as dry as possible in between feedings (except for the topical treatments). For example, if you use nursing pads for leaking breasts, change them as soon as they get damp. Wear cotton bras and wash them often.
- Try nipple shells (not nipple shields). These large domes fit in your bra over your nipple. They create a space to keep your nipples dry while wearing clothing. They can also help with pain by keeping clothing off your nipples.
- Provide a separate towel for everyone in the family. Wash towels in hot water.
- Wash your hands often, especially after changing your baby’s diaper or using the toilet. Wash and sterilize pacifiers, reusable nipple shields, breast pump parts, and toys often.
Can I breastfeed with a nipple yeast infection?
Yes, it’s perfectly fine to breastfeed with a nipple yeast infection. To ease any discomfort, try placing a cool washcloth on your nipples before nursing.
Ask your provider whether you need to wash off the medication you’re using before breastfeeding your baby. (In most cases, it won’t be necessary.) If you do wash it off, use olive oil or coconut oil (instead of soap and water, which can be irritating) to remove any medication on your nipples before breastfeeding. After nursing, rinse your nipples and let them air dry completely, then reapply the medication.
Some moms find the pain of a nipple yeast infection so excruciating that they can barely stand to nurse their baby. If that’s the case for you, pumping your breast milk may be more comfortable. It’s fine to give your baby milk you pumped while being treated for thrush.
Feeding your baby only pumped breast milk is called exclusive pumping, and it may be a good option until your nipples heal.
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