Your breastfeeding experience might have been going well, and then the pain hits without warning. Sharp, burning nipple pain after weeks of comfortable feeds can leave you feeling exhausted and wondering what went wrong. You might worry about your latch or question whether you can keep breastfeeding through this.
In situations like this, you may be dealing with nipple thrush, also known as mammary candidiasis. This is an issue faced by many breastfeeding mothers.
Fortunately, nipple thrush usually responds well to treatment. Recognising the specific signs of thrush, understanding how it differs from other breastfeeding issues such as attachment problems or nipple vasospasm, and knowing when to reach out to your doctor help you get the right treatment quickly instead of spending weeks trying fixes that won't work.
What is nipple thrush?
Nipple thrush is a fungal infection caused by an overgrowth of Candida albicans, a yeast that lives on your skin naturally.
Although yeast infections are most commonly associated with vaginal thrush, the same fungus can also affect the nipples and breasts. Your body usually keeps this yeast balanced most of the time, but it can thrive in warm, moist environments. Damp breast pads, sweaty bras, or milk-soaked skin create perfect conditions for overgrowth.
This is more likely to happen if:
You have recently taken antibiotics
Your have cracked or damaged nipples
You or your baby have recently had thrush elsewhere, such as oral or nappy thrush
Nipple thrush is a fungal imbalance, not a hygiene problem. You haven't done anything wrong. What matters now is treating both you and your baby at the same time. Even if your baby looks fine, they can carry the yeast and pass it straight back to you. This is why the infection keeps returning when only one of you gets treated.
Symptoms to look out for
Thrush pain feels very different from early breastfeeding tenderness. Latch-related discomfort usually eases as a feed continues, but thrush pain tends to linger, intensify, or even appear only after a feed has finished.
Symptoms you may notice include:
Nipple pain that feels burning, shooting, stabbing, or itchy
Shiny areas on your areola or nipple skin that may look red or flaky
Deep breast pain that radiates inward, during or after feeds
Extreme sensitivity to touch, where clothing or breast pads feel uncomfortable
Sore nipples that don’t heal despite correcting the latch
A white rash or tiny blisters on the nipple
Symptoms you may notice in your baby include:
White patches on the tongue, gums, or inside the cheeks that don’t rub off (oral thrush)
A persistent nappy rash that looks bright red, spotty, or slow to heal
Fussy behaviour at the breast or pulling away while feeding
A clicking sound while feeding, which may be caused by mouth discomfort
The burning, shooting pain of thrush can feel similar to nipple vasospasm (Raynaud's syndrome) or the sharp discomfort from blocked ducts, which is why professional assessment matters.
Getting the right diagnosis helps you identify the actual problem, allowing you to start the right treatment sooner.
If these signs sound familiar, reach out to your doctor or lactation consultant. You may schedule an appointment with a doctor or lactation support team at Thomson ParentCraft Centre for further assessment.
Is it thrush or something else?
Diagnosing thrush can be tricky because the symptoms often overlap with other breastfeeding complications.
It is easy to mistake one type of pain for another, which can delay healing by leading to inappropriate treatment and allowing symptoms to persist or worsen.
Nipple vasospasm:
This condition, often linked to Raynaud's syndrome, causes your nipple to turn white, then blue or purple after feeding when exposed to cold air.
The pain is throbbing rather than burning.
Milk bleb (or a milk blister, a nipple bleb):
You may notice a tiny white or yellow spot on the tip of your nipple.
This happens when milk becomes trapped under a thin layer of skin.
The pain is usually sharp and focused on one specific point.
Attachment issues:
When the baby isn’t latching deeply, your nipple will be compressed, causing pain.
This usually stops when the latch is corrected.
Bacterial infection:
If you see pus-like fluid or yellow crusting, this suggests a bacterial cause rather than thrush.
Misdiagnosing the cause means you waste days treating vasospasm when you actually have thrush, or vice versa. Your doctor can assess your symptoms, examine your nipples, and confirm whether Candida albicans is involved, helping you get the right treatment.
What may cause and trigger nipple thrush?
When you understand what causes nipple thrush, it becomes easier to prevent it from coming back.
Here are several factors that may trigger this condition:
Antibiotics:
These medications kill good bacteria along with the bad, allowing yeast to grow unchecked.
Vaginal thrush:
If you have an active yeast infection, it can spread to your baby during birth or through contact.
Damaged nipples:
The fungus can slip through nipple cracks and enter the skin tissues.
Moisture:
Wearing damp breast pads or non-breathable synthetic bras creates the warm environment yeast loves.
Diet and health:
Eating a lot of sugary foods can make it easier for yeast to grow.
Health conditions like diabetes or anaemia can weaken your body’s ability to keep yeast under control.
Medications:
Hormonal birth control can change your hormone balance, which may allow yeast to grow more easily.
Steroid creams can make the skin thinner and more sensitive, making it easier for thrush to develop.
Recognising your specific trigger helps you make targeted changes rather than trying random prevention tactics. Changing breast pads frequently, choosing breathable bras, or treating vaginal thrush promptly are small steps that can stop thrush from developing again.
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What are treatment options?
Once thrush is diagnosed, your doctor will usually prescribe antifungal medicine for both you and your baby. Even if only one of you has symptoms, both need treatment. Your baby can carry yeast even without any visible signs and reinfect you within days of your treatment finishing.
Medical treatment
Here’s what your doctor may prescribe:
Antifungal cream (such as miconazole or clotrimazole) to apply to your nipples after every feed
Antifungal gel or liquid drops (such as nystatin) to coat the inside of your baby’s mouth
Antifungal tablets (such as fluconazole) if creams are not effective or the pain feels deep within the breast
Gentian violet, a purple antifungal dye, used in some cases under professional guidance due to possible skin irritation
To reduce the risk of reinfection, wash your hands well before and after applying nipple creams or giving medication. It is also important to complete the full course of treatment, even if the pain improves quickly, because stopping early can allow the infection to return and cause symptoms to flare up again.
What to do at home
Alongside medical treatment, these home care strategies may help soothe sore nipples and support your recovery:
Rinse your nipples with a vinegar solution made from one tablespoon of apple cider vinegar and one cup of water after feeding
Adjust your diet by reducing sugar and refined carbohydrates and adding probiotics to support healthy bacteria
Allow your nipples to air dry fully after each feed or spend a few minutes topless in a private sunny spot
Relieve pain with cold packs before feeds or warm compresses if that feels more comfortable for you
These steps can help ease soreness and support your healing, especially when your nipples feel sensitive and overwhelmed. However, thrush usually needs medical treatment to fully clear, so these measures work best when used alongside the antifungal treatment prescribed for you and your baby.
If symptoms persist or do not improve, consider speaking with a healthcare professional. You may schedule an appointment with a doctor or lactation support team at Thomson ParentCraft Centre for further assessment.
How to prevent nipple thrush from returning
Hygiene plays a key role in clearing nipple thrush and stopping it from coming back. Yeast can be stubborn and may linger on items that touch your breasts or your baby’s mouth.
Here are a few steps you can take to prevent nipple thrush from returning:
Wash your hands thoroughly before and after feeds, nappy changes, and applying any creams
Boil feeding equipment such as pacifiers, bottle teats, nipple shields, and breast pump parts, especially flanges, once daily for 20 minutes to kill yeast
Wash bras and towels in hot water at 60°C or higher, as lower temperatures may not remove yeast effectively
Change breast pads as soon as they feel damp and avoid plastic-backed pads that trap moisture
Clean toys your baby puts in their mouth by washing them in hot soapy water or using the washing machine if appropriate
If you are exclusively pumping, be extra mindful of your pump parts, as yeast hides easily in valves and tubing.
Throwing away softer silicone pieces after treatment, especially when they are barely used, can feel wasteful and frustrating. Replacing them is important because yeast can linger in these materials and trigger thrush to return.
Changing these parts regularly helps protect the progress you have made and offers reassurance as you continue to heal.
FAQ
Can I keep breastfeeding if I have thrush?
Yes, you can continue breastfeeding. While feeding may feel painful, stopping suddenly can increase your risk of blocked ducts or mastitis. If the pain feels overwhelming, a lactation consultant can help you adjust your baby’s latch or suggest temporary pumping so you can protect your milk supply while treatment starts to work.
Do I need to treat my baby if they have no symptoms?
Yes. Thrush is easily passed between you and your baby, even if your baby looks completely fine. Babies can carry the yeast without obvious white patches, which can lead to reinfection. Treating both of you at the same time is the best way to break this cycle and prevent thrush from coming back.
Is it thrush or nipple vasospasm?
It can be hard to tell, and you are not alone in feeling unsure. Thrush usually causes a burning or itchy pain that continues during and after feeds. Nipple vasospasm, often linked to Raynaud’s syndrome, tends to cause a throbbing pain, and the nipple may turn white or blue, especially in cold air. A healthcare provider can help you identify the cause and guide you towards the right treatment.
Can I use my leftover nipple cream or balm?
No. Once thrush is diagnosed, any nipple creams or balms you used previously may be contaminated with yeast. Reusing them can lead to reinfection, so it is best to discard them and start with new products.
How long does treatment take to work?
Many parents notice some relief within two to three days of starting antifungal treatment. Even if you feel better quickly, it is important to complete the full course, usually 10 to 14 days. Stopping too soon is a common reason thrush returns.
Can I freeze milk pumped while I have thrush?
Freezing does not kill yeast; it only makes it inactive. Using frozen milk later may increase the risk of oral thrush returning. Freshly pumped milk is usually safe to give during treatment, but some experts recommend scalding milk before freezing or clearly labelling it to use later when your baby’s immune system is more developed.
Can I use gentian violet?
Gentian violet can be effective against yeast, but it is messy and can stain skin and clothing. It may also irritate the skin if used too often or in high strength. It is best used only with guidance from a healthcare professional, especially if other treatments have not worked.
The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.