A Yeast Infection of the Breast
Nipplethrushis ayeast infectionthat is common during breastfeeding.
It causes red, cracked, and itchy nipples and burning or stabbing breast pain after feeds.
Thrush on nipples often occurs alongside oral thrush in the nursing infant.
Verywell / Jessica Olah
Both oral and nipple thrush are treated with topical antifungal medications.
This article discusses nipple thrush.
It explains what thrush on the nipples looks and feels like and how to find relief.
This photo contains content that some people may find graphic or disturbing.
Verywell / Jessica Olah
How Do I Know if I Have Thrush on My Nipples?
Symptoms of oral thrush include:
What Causes Nipple Thrush?
Nipple thrush is due to an overgrowth ofCandida, a yeast normally present on the skin.
It is most common during the first six weeks of breastfeeding but can occur in non-nursing people as well.
It can pass from the mother’s nipple to the child’s mouth and vice versa.
Risk factors for developing thrush on your nipple include:
Is Nipple Thrush Contagious?
Yes, thrush can spread between a breastfeeding parent and a nursing child.
The infection can begin either in the baby’s mouth or on the breast.
You and your baby may continue to pass thrush back and forth until both are fully treated.
How Is Thrush on Nipples Diagnosed?
Nipple thrush is usually diagnosed based on symptoms of both the parent and child.
It is considered a diagnosis of exclusion, meaning healthcare providers eliminate other causes before diagnosing thrush.
The pediatrician will sometimes diagnose and treat nipple thrush in the parent of a baby with oral thrush.
It can also be diagnosed by a gynecologist, primary healthcare provider, or dermatologist.
Lab tests are not necessary for diagnosing thrush.
Other Causes of Nipple Pain
Nipple pain and irritation can be triggered by something other than thrush.
Symptoms of nipple thrush may be mistaken for other types of nipple pain in breastfeeding adults.
Early Breastfeeding Discomfort
Thrush is most common during the first six weeks after childbirth.
However, this is also a notoriously uncomfortable period for those new to breastfeeding.
Sore, irritated nipples and breast discomfort are common in the early days of nursing.
Milk-duct contractions, commonly referred to as let down, and breast engorgement may be painful in the beginning.
However, this pain should be relieved by nursing, pumping, or hand-expressing milk.
Improper Latch
Nipple and breast pain during feeding can be sparked by poor positioning or an improper latch.
This can also lead to blisters and sores.
A lactation consultant can help ensure your baby is latched correctly and offer tips for successful feedings.
Clogged Milk Duct
Breast and nipple pain can also be because of a clogged milk duct.
A clogged duct can often be relieved by nursing or expressing milk while massaging the area.
Mastitis
A clogged milk duct can turn into an infection known as mastitis.
Topical antibiotics may be prescribed if nipple thrush is accompanied by a bacterial infection.
This is common in individuals with nipple fissures, which often occur alongside nipple thrush.
Topical steroids may be prescribed to treat very inflamed nipples.
Combination antifungal and steroid treatments are also available.
If topical treatments fail to relieve thrush, oral antifungal medication may be prescribed.
Otherwise, thrush is likely to return.
Treatment options for infants with oral thrush include oral antifungal medications fluconazole and nystatin.
Apple cider vinegar (ACV) is an oft-recommended at-home remedy for nipple thrush due to its antifungal properties.
While research in humans is lacking, lab studies confirm ACV effectively killsCandida albicansin a petri dish.
Directions:Dilute 1 tablespoon ACV in 1 cup of water and apply between feedings to nipples.
Do not use on cracked or bleeding nipples.
Can You Still Breastfeed With Thrush?
Breastfeeding with nipple thrush is safe for both parent and child, though it may be uncomfortable.
Thrush on nipples is associated with oral thrush in the infant.
Oral thrush is a relatively common and generally mild infection and not a reason to stop breastfeeding.
That said, both the parent and baby will need to be treated for thrush.
This will reduce the likelihood of the pair repeatedly passing thrush back and forth between them.
Coping With Nipple Thrush
Nipple thrush can make breastfeeding painful.
Fortunately, thrush is usually quite responsive to treatment.
You should start to feel relief after two or three days of starting antifungal treatment.
Some strains ofCandidaare resistant to certain medications.
You may need to try a different antifungal treatment.
Goldstein L.Nipple thrush: how to identify and how to treat[published correction appears inMidwifery Today Int Midwife.
2015 Summer;114:68].Midwifery Today Int Midwife.
2015;(113):18-19.
2020;12(12):e12026.
A cohort study in Melbourne, Australia.BMJ Open.
2013;3(3):e002351.
2012;51(10):1149-1161. doi:10.1111/j.1365-4632.2011.05445.x.
Drugs and Lactation Database(LactMed) [Internet].
Bethesda (MD): National Institute of Child Health and Human Development; 2022.
Arendrup MC, Patterson TF.Multidrug-resistant Candida: epidemiology, molecular mechanisms, and treatment.J Infect Dis.
2017;216(suppl_3):S445-S451.
