What Do I Need to Know About Thrush?

Encountering issues like thrush can add an unexpected hiccup in the already complex roller coaster that is taking care of a new baby. Understanding what it is and how to manage it, should it arise, can help you keep your feeding journey on track.

What is Thrush?

Thrush, also known as candidiasis, is a fungal infection caused by the overgrowth of Candida albicans. It commonly affects moist areas of the body, such as the mouth, nipples, and diaper area in infants, and because it can be transmitted between breastfeeding parents and their babies, it can lead to multiple infections and reinfections between mom and baby.

What are the signs and symptoms?

Recognizing the signs of thrush is essential for early intervention.

Symptoms in mom might include:

• Nipple Pain: Persistent, usually burning pain in the nipples, often experienced during or after breastfeeding sessions. Nipples may also be very sensitive or even itchy.
• Nipple Discoloration: Nipples may appear pink, red, or shiny, sometimes with flaking or peeling skin of the nipple or areola. May also have white patches or blisters on the nipple.
• Shooting Pains: Intense shooting or stabbing pains in the breast during or after feedings.
• Cracked Nipples: Thrush can worsen nipple damage, leading to cracks, sores, or blisters that don't heal.

Symptoms in infants might include:

• White Patches: White patches on the inside of the mouth, tongue, or cheeks that do not wipe off easily, or become red or even bleed when wiped off. 
• Fussiness During Feeding: May become fussy or irritable during feedings due to discomfort.
• Diaper Rash: Can cause a persistent, red diaper rash that does not improve with usual treatment.

What do I do if I think we have thrush?

Call your healthcare provider or your baby’s healthcare provider to request an appointment for evaluation if you believe either of you is dealing with stress. Treatment typically involves treating both mom and baby simultaneously, even if only one of you has symptoms.  Common treatment options may include: 

1. Antifungal Medications: Topical antifungal creams or oral medications may be prescribed to eliminate the Candida fungus.
2. Topical Steroids: If nipple damage is severe, a steroid cream may aid in the healing process. 

If you and/or your baby has been diagnosed with thrush, there are some additional things you can be doing to make yourself more comfortable, speed your recovery, and prevent reinfection. Because thrush can be easily spread back and forth, it’s important to practice good hygiene and cleaning practices. Things you can be doing while being treated for thrush might include:

• Frequent hand washing.
• Keep nipples dry, and allow them to air dry after feedings. Avoid breast pads, if possible, or throw away/change them frequently. Change your nursing bra frequently, especially if it is consistently damp. 
• Wear 100% cotton bras and underwear.
• Wash towels and clothing in hot water to kill yeast organisms.
• Wash and sterilize bottles and nipples, pump parts, pacifiers, and teethers frequently.
  • The CDC recommends sterilizing bottles and pump parts once a day for babies less than 2 months or if baby was born premature or has a weakened immune system. If you’re battling thrush, focus on adequately washing all pump parts, bottles, pacifiers, etc. very well, sterilizing as appropriate. 
• Avoid excessive added sugar, as high-sugar diets have been shown to make you more susceptible to yeast overgrowth.
• Take mild over-the-counter pain medication if needed while getting symptoms under control.
• If feeding is too painful, pump and hand express milk and offer it to your baby by another means in the short term. If you can tolerate feedings, there is no reason to discontinue breastfeeding while treating thrush.

Need more help?

If you think you or your baby has thrush, reach out for help right away to figure out exactly what’s going on. If you’re struggling with feeding while getting the infection under control, reach out to a lactation specialist for additional support. Lean on your support system as much as you can to help with the extra cleaning and to give you some much needed time to take care of yourself! 

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