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Thrush and Breastfeeding
Read time: 6 minutes
What to know about breastfeeding with thrush
What is thrush?
What are the signs and symptoms of thrush in babies and mom?
How is thrush treated and how can I help prevent it from coming back?
Can I use my frozen milk that was pumped when I had thrush?
Thrush, also called candidiasis, is an infection caused by a fungus that thrives on warm, moist areas. Unfortunately, baby's mouth and mom’s nipples are perfect places for this type of yeast infection to develop.1
Because thrush can cause pain both for baby and mom, it can interfere with both baby’s ability to feed as well as the mother’s ability to produce breastmilk.34
Read on to learn more about a thrush infection and how to manage it.
What causes a thrush infection?
The fungus that causes thrush, candida albicans, is commonly found on our body and normally does not cause any problems.3 Yet when it’s left to overgrow, it may cause an infection with painful symptoms.
Common causes of thrush include:
Medications. Antibiotics often kill off “good” bacteria which may allow yeast to overgrow. Additional medications that may put someone at higher risk for thrush include steroids and oral contraceptives, among others.
Immature immune systems. Babies, particularly newborns, do not have fully developed immune systems, making it easier for too much yeast to grow.
Moist environments. Both the mouth and the nipple are prone to infections since they are warm and moist. This, combined with factors such as not letting the nipples dry between feedings or pacifier use for the baby, may put moms and babies at higher risk for developing thrush.
Poor latch. If a baby is not latching well and causing damaged, cracked nipples, that may provide the perfect place for candida albicans to grow.
Signs and symptoms of thrush
Symptoms of thrush in mom
Intense nipple or breast pain during and/or after nursing, not relieved by an improved latch. Some women experience pain during breastfeeding, while others have no pain while breastfeeding but feel pain after baby finishes breastfeeding for about an hour.
Thrush normally affects both nipples, not just one.
Nipples that may be red, sore, cracked, burning, or painful. Many people experience itchiness or a burning pain between feedings.
Areola that may be red, swollen, flaky/scaly, or shiny
Pain could be deep inside the breast
The onset of symptoms is often very sudden
Learn more: Causes and Symptoms of Mastitis during Breastfeeding
Symptoms of thrush in babies
Yeast diaper rash. Red, raised pustules or red rash on the buttocks.
White patches in the mouth and on the tongue that cannot be washed away or gently wiped off. It can spread to the gums, cheeks, and lips. This can be painful for baby and may make feedings difficult.
Slow weight gain
It’s important to note that most babies get a white coating on their tongues from breastmilk or infant formula, so having a white coating alone does not necessarily mean thrush is present. The white coating from formula or breastmilk generally wipes off easily, while thrush does not.29
It is also possible that babies may not have any symptoms at all.
Learn more: Top Breastfeeding Latching Tips
If you have questions about symptoms of thrush, reach out to our team of registered dietitian nutritionists and lactation consultants for free! They’re here to help on our free to live chat from Monday – Friday 8am-6pm (ET). Chat Now!
Is thrush contagious?
Yes, thrush is quite contagious. In fact, mothers and babies often pass this infection back and forth until the infection is resolved.
This is why it’s very important to treat thrush in both baby and mom at the same time.69
The good news is that you can continue to breastfeed your little one during an infection as long as you are both being treated.6
Treatments for thrush
If you have been diagnosed with thrush, both you and your baby must be treated at the same time.
Your healthcare provider, as well as your baby’s pediatrician, may prescribe one of the below treatments:
A cream to use on your nipples after breastfeeding.
An oral medicine that often needs to be taken for a specific amount of time, such as up to 14 days
A solution to swab inside your baby’s mouth
Once medical treatment starts it may take up to 2 weeks for the infection to fully resolve.3 Remember that you can still nurse if both you and baby are being treated!
*Note that many other over-the-counter supplements may be recommended by friends, family, or internet searches. Be sure to check with your healthcare professional or your baby’s pediatrician before you or your baby take any new supplements or treatments.
Can I pump and save breastmilk while I have thrush?
Freezing milk deactivates yeast but does not kill it. Even while yeast may still be present in the milk, there is currently no evidence that milk stored during a thrush episode will cause reinfection when drunk later.9
According to the Academy of Breastfeeding Medicine, milk expressed while a mother has thrush does not need to be thrown out.13
If a person is still concerned that pumped milk may cause reinfection, the milk may be heated to 144.5°F for 30 minutes to kill the yeast. Yeast will also be killed in less than 5 minutes at a temperature of 122°F.
Be sure to allow the breastmilk to cool to body temperature before offering it to baby.
Out of caution, many people choose to use breastmilk pumped during a thrush infection only while mother and baby still have thrush and are being treated.
Learn about:
Top Tips for Pumping Breastmilk
Safe Storage of Pumped Breastmilk
Tips to help manage and prevent thrush
Take the full dose of medication or ointment as prescribed
Often treatments will only work if they are used for the prescribed period of time. Do not stop taking the medicine, even if you start feeling better before you’ve completed the full treatment.10
Speak with your healthcare provider should you have questions about any medication they prescribe.
Manage your pain
Pain has been shown to reduce the breastmilk ejection reflex (the ‘let down’, or what makes breastmilk flow) for some women, which may ultimately lead to a lowered supply.15
Ask your healthcare provider which medications are safe for you to take to help reduce pain so that you may continue breastfeeding.
Pump if baby is not able to breastfeed
If your little one is in pain, they may be less willing to breastfeed. If they stop early or refuse completely, be sure to pump both breasts until empty.16 This will help ensure your supply does not reduce during this time.
Should your infant be refusing to breastfeed, or not be breastfeeding enough, make sure to supplement baby with either pumped breastmilk or formula. Pump as many times as baby gets a bottle to help maintain your breastmilk supply.
Read more:
Breastfeeding: How to Support a Good Milk Supply
How do I Supplement my Breastfed Baby with Formula?
Keep your nipples dry
Gently pat your nipples dry after breastfeeding and/or let them air dry for a bit before covering them with a nursing bra or shirt.9 Always let your nipples dry before applying any prescribed creams or ointments.
Be sure to change breast pads as soon as they become wet.10 Using 100% cotton bras and underwear can help keep those areas dry by preventing moisture from becoming trapped.
Learn about: What to do about Sore Nipples while Breastfeeding
Keep your baby’s bottom dry
If your little one has a diaper rash, keeping it dry is important. After gently wiping your baby’s bottom, let it air dry or gently pat dry.11 Apply the prescribed ointment and then only after the bottom is dry, apply the diaper cream.12
The cream will help create a moisture barrier to keep baby’s bottom dry, but if the bottom is still wet, the cream may make the rash worse by trapping the moisture in.
Change your little one’s diaper as soon as it becomes wet.
Wash anything that touches your breasts or your baby’s mouth
The candida albicans fungus can live on many surfaces.6 Washing and sanitizing can help kill the fungus and help prevent the infection from coming back or spreading.
Wash your hands thoroughly in warm soapy water before and after breastfeeding, pumping, or handling breastmilk.6 Consider using paper towels for hand drying to help eliminate passing around the infection with the use of towels.
Items to wash or sanitize when you and baby have thrush:
Sterilize all breast pump parts that touch the breast each day. Wash all items in hot soapy water first and rinse thoroughly. Boil in a covered pot of water for 10-20 minutes. Allow the items to air dry
Wash and then boil all items that come in contact with baby’s mouth after each exposure, such as toys, pacifiers, bottle nipples, and teethers. If possible, discard the pacifiers, nipples, and teethers after 1 week of treatment and purchase new ones
If toys cannot be boiled, wash them with hot soapy water frequently
Bras, bra pads, pajamas, etc. must be washed in HOT water and/or bleach and dried either in the sun or on the hot setting on your dryer16
What if it’s not thrush?
It’s very common to mistake pain from a poor latch, improper positioning, and cracked nipples for thrush pain. It’s important to have a healthcare provider and lactation consultant evaluate your symptoms.
Testing the milk for candida albicans is an option in cases where the symptoms are questionable or haven’t resolved with the usual thrush treatments.
Contact your healthcare provider ASAP if you have signs and symptoms of thrush.
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Our Happy Experts are a team of lactation consultants and registered dietitian nutritionists certified in infant and maternal nutrition – and they’re all moms, too! They’re here to offer personalized support on our free, one-on-one, live chat platform Monday - Friday 8am-6pm (ET). No appointment needed, no email or sign-up required. Chat Now!
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For more on this topic, check out the following articles:
Dealing with a Low Breastmilk Supply
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