Everything You Need to Know About Thrush While Breastfeeding (for mama and baby!)

Last Updated: February 13, 2024
Liesel Teen, RN-BSN

By Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

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If you’re anything like me, mama, you have heard of thrush and maybe even had it. If you’re really unlucky you have it RIGHT NOW, which might explain why you came to me.

In a perfect world, everyone would know how to prevent thrush while breastfeeding. Or better yet, not have to even worry about it.

Well mama, you’ve come to the right place. As a labor and delivery nurse, I get asked a lot about what to do to prevent thrush while breastfeeding and, if it happens, what to do about it.

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What is breastfeeding thrush and what causes it?

It goes without saying that thrush while breastfeeding can be very common. Thrush breastfeeding can be disconcerting at best, and painful at its worst.

If you’re wondering to yourself “Is thrush contagious?” look no further for your answer. Technically, sure, the sheer volume of spores that cause thrush can be displaced from one person’s skin to another’s.

Bottom line, any time you have fungus, it can (and will) breed. If one surface is brushed against another, fungus can and most likely will spread from one surface to another.

If I’m treading lightly with the topic, it’s because even though you might be sharing more fungus if you have an outbreak of thrush, you’re sharing more of what is already there.

On everyone. Everywhere. All the time.

Is your body able to stave off the fungus?

The ONLY difference when this cross-contamination occurs is whether or not the existing beneficial bacteria are enough to stave off colonization. Your ability to fight off fungus determines whether or not an actual outbreak of thrush occurs on either end of the exchange.

If you find that you have issues with recurring thrush while breastfeeding, it’s more likely that your habits or rituals are to blame. If your habits are great, though, it might be worth getting seen, since it might indicate an imbalance in your body’s beneficial bacteria.

To prevent thrush while breastfeeding is more a question of how easy you’re making it for fungus to thrive and have lots of adorable little fungus babies.

Thrush and yeast infection

If you are told that you’ve contracted a yeast infection while breastfeeding, chances are, this is thrush.

Thrush is the term to describe excess colonization of Candida albicans, a yeast-like fungus that is actually always present on and inside the human body.

This little fungus is basically harmless and tends to live in the mouth, stomach, or areas of skin that are prone to staying a bit more dark and moist. The excess of this fungus results in infection and potentially inflammation.

Excess, you say? What does that even mean?

Yeast and fungus thrive on sugars, which is how beer gets carbonated, and bread rises. They also do their very best work in wet or humid environments and darkness.

So, what do we know that is frequently wet while breastfeeding, leaks sugar whether you want it to or not, and doesn’t tend to see much sunlight unless you live in Europe?

Yep, you guessed it. The answer is breasts.

When you breastfeed, you are creating the perfect cocktail for an excess of yeast colonies. Because walking around topless isn’t a thing, you’ll probably have to accommodate for this circumstance in other ways.

Happily, I can say with some confidence that thrush is not a dangerous condition. Gross, sure. A little uncomfortable? Absolutely.

Thrush can be a cause for concern in adults, as we usually have everything we need to fight it off. The exception is breastfeeding, where thrush is a little more commonplace even without an immune issue in play.

Related Reading: Understanding the Dysphoric Milk Ejection Reflex

Signs of thrush in babies

Thrush in babies tends to be a colonization of Candida albicans inside the mouth of your lovely little newborn and manifests in the form of white spots or a white coating in the mouth.

It will be particularly evident on the tongue, and sometimes on the inside cheeks or gums. You will notice this any time the baby yawns or coos or pokes out their little pink tongue.

If you think you see it, don’t panic. Thrush is not the end of the world. Your doctor can help you understand it a little better if you don’t get what you need here.

What does tend to happen when you’re breastfeeding with thrush is that mama and baby pass it back and forth to each other. This is why it’s usually important to treat BOTH mama and baby with an antifungal, whether both are showing symptoms (yet) or not.

Related Reading: How Long Does Caffeine Stay in Breast Milk?

Newborn Thrush vs. Milk Tongue

Milk tongue is a relatively common condition that results from–yep, you guessed it–milk frequently passing across baby’s tongue.

Deposits of milk cling to the tongue, resulting in a white and sometimes yellowish patina lining your little one’s tasters. This stuff is pretty constantly being scrubbed against the baby’s palate and so not all babies ever even show it off.

Because of that, some babies may have a whiter tongue than your average milk monster.

Related Reading: Awesome Breastfeeding Tips

Thrush in the mouth

Thrush in babies occurs in the mouth, and can easily be mistaken for milk tongue. For your little one, it also presents as white or sometimes yellow coating across their tongue.

So, how do you tell the difference between thrush and milk tongue? Easy: try to rub it off with your finger or a damp cloth.

Because milk tongue is a residue deposited from the frequent passage of milk over the tongue, that residue can be scrubbed away.

The coloration caused by thrush, on the other hand, is the result of infected membranes inside the flesh of the tongue. No amount of rubbing will take the color away (and you definitely shouldn’t try that hard).

For the most part, doctors generally seem to believe thrush is relatively harmless for babies. As with any fungal outbreak, places where the skin goes from wet to dry often might be impacted by some redness and cracking.

For babies with thrush, this would typically mean dry or cracked lips. You can also sometimes see lesions inside the mouth but open sores are pretty rare, based on the cases I’ve ever seen.

Thrush diaper rash

There is a common claim that thrush can cause a diaper rash. While this isn’t strictly true to the best of our knowledge, the two can come in a package deal.

Yeast of ANY kind can result in skin irritation. A lot of professionals believe that the kiddo is more susceptible or at least more at-risk for diaper rash if they already have a thrush outbreak.

The long and short of it is that these are two separate symptoms and potentially only linked to a degree in cause. Regardless, they also have separate and distinct remedies and neither of which have much cross-over.

To be sure, those medicines or remedies meant for the butt should stay out of the mouth. And that medicine or remedy meant for the mouth should stay out of the butt.

Related Reading: Breastfeeding not an option? Have You Thought about Exclusive Pumping?

Thrush breastfeeding symptoms in mom

What we know about how much discomfort a baby undergoes when infected with thrush is limited. Until we learn to speak baby, we’ll just have to assume that it’s probably not that big of a deal because it doesn’t seem to result in blue-faced screaming.

Thrush symptoms in mom, on the other hand, undergo a lot of speculation. If you have to ask “How do I know if I have thrush”, chances are… you have thrush. Unless you’re just being proactive.

Regardless, it’s good to have a strong grasp of the signs and symptoms of a breast yeast infection in order to prevent thrush while breastfeeding, or so that you can identify what is thrush and not something worse.

There are a few things that might be assumed to be thrush that could be more serious or potentially painful conditions downstream. The sooner you identify those, the better off you’ll be.

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1. Check your nipples

So what does thrush on nipples look like? You’ll typically see white spots and potentially some dryness and cracking on your nipples. If you have spots that look harder or shinier than your typical nipple flesh, chances are that’s thrush.

2. Itchiness

One symptom that appears to be pretty unanimously agreed upon is that you can have an itchy body while breastfeeding. Anyone who has had athlete’s foot can attest to the itchiness of some fungal infections.

Now, thrush isn’t supposed to be anywhere near as bad as all that, where skin flakes away in droves and an infuriating itch that you can’t quite reach inside your shoe.

The thrush itch is a small, localized irritation that is likely the result of those little flakes tickling while your skin heals beneath.

3. Pain in the breast

Symptoms of thrush for the breastfeeding mom also potentially include sharp pain while breastfeeding (shooting pain) and letdown pain. Some women describe it as an ache or a burning pain that extends through the entire breast and sometimes both breasts.

4. Rule out other culprits

Breastfeeding thrush symptoms can ultimately be a little misleading and elusive, though.

If you have sharp pain, for example, that could easily be a plugged milk duct.

If you have an itching sensation but no white or shiny spots on your nipples, you might just have an itch. Best solution is to scratch. If it persists, though, keep an eye out for other symptoms.

5. Better to get checked than not WHENEVER you’re experiencing breastfeeding pain

Ultimately, there is peace of mind in knowing that a breast yeast infection due to thrush is not typically a serious condition (although yes – you should still see your doctor!)

It’s worth talking with your doctor if the itching is too unbearable or any pain or discomfort might put you at risk for weaning your little youngster early to avoid prolonging the condition.

It’s always better to wean later. Most doctors recommend breastfeeding at least through the first 12 months. For this reason, it’s important to solve any concerns that threaten to draw this time to a premature close.

Related Reading: When Should I Stop Breastfeeding?

How to prevent thrush while breastfeeding

Given that thrush is a fungal infection resulting from little soldiers you already wear around every day, preventing thrush while breastfeeding is a tough deal. There are certainly things that can always be done.

More often than not, though, it’s a question of good hygiene and thinking through the impact of what you do when and after breastfeeding. When push comes to shove, your body already does most of the things that need to be done

Remember to look back to the cause if you seek to find the solution.

Want to boost your milk supply? Try out these DELICIOUS Mommy Knows Best cookies!

What causes thrush?

As mentioned before, the particular brand of fungus that causes thrush is called Candida albicans. This yeastie beast is always present on human skin.

It likes darkness and moisture, so you can expect to carry them around in your armpits, between your toes, and other places the sun doesn’t typically shine.

Ordinarily, beneficial bacteria chow down on fungus like this, so your best offense is a healthy system on which these little dudes can thrive in equal or greater measure than the surplus of fungus and sickness-causing bacteria.

Keep a good supply of beneficial bacteria and you can expect your fungus to stay at a minimum.

This is interesting because typically we think of beneficial bacteria as being something that we have only in our GI tract. The truth is we have them on our everywhere. And inside our everything.

They are working all the time to maintain a balance and keep our bodies healthy (not that they probably know that).

One reason why we tend to get fungal infections like this is that we are treating our bodies for bacterial infections, such as a staff infection or E Coli poisoning.

Unfortunately, antibiotics don’t know the difference between the good guys and the bad guys. It’s mutually assured destruction you can always expect when you drop the penicillin bomb. That’s why we tend to get diarrhea or yeast infections when we take strong antibiotics.

More on antibiotics and the link to thrush below.

Best treatment for thrush

The idea that you can prevent thrush while breastfeeding is great. If you’ve got it, though, you gotta get rid of it. We’ll focus on prevention once there’s something worth preventing.

Before that, let’s talk about treating symptoms and possible ways to smack down the headcount on your unwelcome fungal freeloaders.

Typically, it’s recommended to medicate for thrush, so this is definitely something you’ll want to see your doctor for.

Thrush breastfeeding natural remedies

As with most things relating to motherhood, I would always prefer to go natural right up to the point where I can’t anymore – but natural remedies for thrush should be used in conjunction with medical treatment – not on their own.

Rinsing your nipples with a vinegar and water solution (1 tbsp of apple cider vinegar to 1 cup water) or baking soda (1 tbsp to 1 cup of water) can help. Fungus requires a certain level of pH balance, and a base like vinegar or soda will throw that balance way off for them.

Some of these natural remedies for thrush can be incredibly easy to administer (you’ll find out why), but definitely always defer to your doctor’s recommendation if you’re introducing too much of anything into your baby’s mouth and, inevitably, their diet.

Remember that these solutions are anecdotal and not necessarily backed by scientific research. Most products you’ll find in the homeopathic space haven’t been evaluated by the FDA, so be sure to run them past your doctor or pediatrician first–I like to take a picture of the labels online and thumb through them with my doc first.

To help rid your infant or your nipples of thrush:

  • Swab the affected area with pure coconut oil (virgin, no artificial additives) which has antifungal properties
  • Dilute apple cider vinegar or white vinegar and gently coat the affected area with this solution 1-3 times daily
  • Spread a light coat of yogurt (plain, unsweetened) across the affected regions
  • Wash EVERYTHING that comes into contact with you or baby to prevent the passing back and forth
  • Introduce a light swabbing of lactobacillus acidophilus to the area (if you don’t know what this is, skip it or read about it here)
  • Use a homeopathic remedy like Candida Detox, Gentian Violet, or take some prebiotics like Dr. Tobias Prebiotics (food for beneficial bacteria) to strengthen your existing supply of the good guys

If you are looking for breastfeeding pain relief, a hot and cold compress to reduce swelling and ease soreness might be just the thing.

Oral thrush treatment over the counter

By and large, the over the counter products that exist to help with oral thrush and nipple thrush from breastfeeding tend to be similar in form and function.

There are anti-fungal creams that can be applied topically, although they employ a bit less power than what you can expect to receive from your doctor.

One over the counter option to treat and even prevent thrush while breastfeeding will likely still be a good probiotic treatment, whether topical probiotics for healthy skin or ingested probiotics for internal balance.

The best probiotic for breastfeeding moms is a matter of some debate. Ultimately, you have access to them every day in your grocery store, whether from the pharmacy or the dairy aisle.

I wouldn’t overthink this one, honestly. I’ve provided some good options above. Really, though, if you can stomach yogurt, it’s the easiest and most immediately available source of probiotics. It also just happens to come in a hundred flavors and go fantastically with Grape Nuts or granola.

Related Reading: The Ultimate Online Breastfeeding Course

Giving your breastfeeding baby a probiotic

If you can’t stomach it, at least do a little slathering. It’s cold and creamy and will feel amazing on your world-weary skin, thrush or no thrush.

The bigger challenge tends to be how to give a breastfeeding baby probiotics. You’ll absolutely want to consult your pediatrician before introducing anything like this into a baby’s diet if you’re below the age for table foods.

If you don’t have your pediatrician’s buy-off yet, pause here and pick up the phone.

Once you have the green light, there are a few options available. A little yogurt in the mouth is a very real option, as long as you aren’t administering it by the spoonful. The idea is definitely to swab it as a palliative, not pipe it in as a food item.

Otherwise, a few probiotic drops will probably stay inside if you’re quick and tricksy with the baby. This all organic probiotic is not evaluated by the FDA. Again, be sure to bring your kiddo’s doctor on the journey with you.

Medical treatment of thrush

Antifungal creams or oral treatments can be administered to solve for particularly rough cases, although Candida albicans can sometimes be very resistant to this kind of treatment.

Doctors will commonly prescribe topical Nystatin or oral Fluconazole for oral thrush in babies. In both cases, it’s better to just swab the area with whichever of these the doctor prescribes.

Be sure to follow their instructions over any recommendation you get on the Internet, though. Even mine. And most importantly, don’t try EITHER of these unless explicitly prescribed them by your doctor and for this purpose.

How to prevent thrush while on antibiotics

Ultimately, the very best treatment for thrush (for you and baby) is the prevention of thrush. Do the right things to make it so you never have to find out what thrush is like. That’ll be a lot better than figuring out how to get rid of it.

When you use antibiotics to fight a bacterial infection, your system has no way of differentiating between the good bacteria and the bad. Both the good guys inside your body and outside of it can take significant losses from antibiotic treatment.

This is why it’s PRETTY common to see breastfeeding thrush outbreaks hand in hand with mastitis. It goes a little something like this:

  • Mama has some nipple soreness and maybe even a laceration (open sore on the nipple)
  • Mama gets a clogged milk duct because baby sleeps longer than expected, or from her underwire bra digging in
  • Clogged milk duct progresses to a breast infection (full-blown masitis)
  • Mama needs an antibiotic to treat the infection
  • Antibiotic makes her susceptible to thrush (especially because she already has those lacerations)
  • Mama gets thrush which causes new breastfeeding pain
  • Baby gets thrush in the mouth and it starts getting passed back and forth
  • Both need treatment

Whew! It’s a tough circle to get into, and one that has to be addressed. I see too many mamas fall off the breastfeeding wagon when this series of events unfolds. But with determination it will all heal. YOU CAN DO THIS! I know it’s hard.

If you do have to take antibiotics while breastfeeding…

So. If you have to take antibiotics while breastfeeding, it’s advisable that you make triple sure that Candida albicans don’t have any extra food on which to thrive.

We talked about the food chain quite a bit but only glossed over what Candida albicans’ in it for. The answer is milk. Sweet, sugary breastmilk is a perfect food supply for bacteria.

Couple that with your adorable breastfeeding baby, and you have the perfect storm of bacteria.Particularly if your probiotics are suffering from antibiotic treatment.

The solution, then, is to make sure the milk goes into the baby and not down your body. Here’s a couple of ideas.

  • Clean yourself immediately after feeding
  • Use soap sparingly to avoid decimating beneficial bacteria but ensuring the milk is entirely washed away
  • Be sure the bottle’s dry before it goes back into the cupboard if you get my meaning.
  • Be sure to thoroughly rinse all affected areas when baby spits up, too.
  • Think twice about what you put on your breasts over and over again. Do you have ice packs you use to ease your sore nipples? Do you have leakage pads that you’re reusing throughout the day?

Take away what the thrush needs to survive!

The answer is to starve Candida out. Naturally, you can’t stop the interchange between mouth and nipple. What you CAN do is let only the necessary amount of exposure occur.

Recent increases in study of the skin “microbiome” (the wonderful world of skin bacteria) have shown that the health of these external passengers (the good and the bad) might have a significant impact on what’s happening inside, and even upstairs.

One thing that stands out as a recommendation for encouraging good bacteria is to eat a significant source of what we call prebiotics.

These are the aforementioned plant-based fibers that we can’t digest, and bacteria are necessary to get rid of them. Getting this inside can help get more good bugs inside AND outside.

Some really great sources of prebiotics are really common fruits and veggies. Bananas, garlic, onions, and oats are a great start. Luckily, we already tend to take in a lot of this kind of stuff. If not, get started, mama.

Related Reading: Best Gifts for Breastfeeding Moms

Ductal thrush

One point of confusion that comes up quite often is whether sharp pain in the breasts is due to ductal thrush or a blocked milk duct.

The truth is that there may not be any way to know for sure. The good news is that neither is necessarily a dangerous condition, even though both can be quite painful at times.

The fix for ductal thrush is more or less the same as any other kind of thrush. Remove the food supply and make an inhospitable land of your breasts.

A blocked duct, on the other hand, can sometimes be soothed by the use of a hot pack to decrease the size of the infected area.

Anything more than that and you should check with your doctor.

Final considerations for preventing thrush while breastfeeding

Ultimately, there’s a lot to consider and SOOOO much more happening than you’d ever think where skincare and thrush prevention is concerned. The breastfeeding mama has a lot to do, and worrying about microbes isn’t always first on our minds, is it?

Well, fortunately enough, your doctor will probably never tell you “I’m sorry, my dear, but the thrush has moved to your lymphatic system”. They’re more likely to tell you “Your baby is so darn cute even with thrush.”

Whether you are seeking medical treatment of thrush or just shooting to prevent thrush while breastfeeding, you are stronger than any little fungus and you’re doing an amazing job.

Hang in there mama!

Comment below and tell me how your experience with thrush went!

Related Reading: How to Ease Pain While Breastfeeding

Related Reading: Best Bottle Feeding Equipment

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Liesel Teen, RN-BSN

Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

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