Thrush and Breastfeeding

Written by Jennifer Clark IBCLC September 2026

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Can Thrush cause pain with breastfeeding?

 

Over the last 10 years thrush has been blamed for nipple pain and soreness with little scientific evidence for the reasoning. Thrush infection is thought to be caused by overgrowth of the candida species and this fungus can cause oral thrush in the mouth in babies as well as nappy rash. Recently, breastfeeding specialists have questioned the scientific rationale for the ability for thrush to grow on nipples and it is controversial as to whether this exists. Over the years many women will have been treated with thrush treatment and found that it improves the symptoms, however, this is likely due to the anti-inflammatory properties of the treatment given.

 

Causes of symptoms are likely to be due to the baby not being latched correctly or if a mother has dermatitis, eczema, vasospasm or neuropathic pain of the nipple. Some women also have reactions to certain creams or products used which can cause similar symptoms. Therefore, always seek out quality breastfeeding support (ideally IBCLC or breastfeeding counsellor) to look at how baby is feeding prior to starting any prescribed treatment.

 

Symptoms of thrush or an alternative diagnosis?

 

• Itching and burning nipples that continue after and between feeds, as well as deep breast pain which may be stabbing or burning.

• Sore and sensitive nipples, skin may be shiny or flaky or inflamed and red.

• Loss of colour/skin discolouration.

 

The following can also cause the symptoms outlined above.

Poor positioning and attachment with breastfeeding can cause:

• Pinched or flattened nipples post breastfeed

• Burning pain in the nipples

• Blisters

• Deep breast pain

 

This maybe due to the following:

• If the baby has difficulty latching - Positioning and attachment

• Tongue tie 

• Trauma to the nipples resulting in bacterial infection.

• Vasospasm of the nipples (maybe linked with raynauds syndrome) – women will see a colour change in the nipples from pink to white and even blue in some cases.

• Eczema, dermatitis or psoriasis can cause dry, itchy, red skin.

• Maybe caused by an allergic reaction to creams, traces of foods in older babies, allergy to silver cups etc. If you have used any new products which coincide with soreness this may be the cause.

• Poorly fitting breast pumps or breast pump set too high - Fitting a breast pump

• Differences in anatomy – small mouth/large nipples

 

Get support – IBCLC home visits and Breastfeeding Cafes

 

Babies can get oral thrush, however, thrush is now not thought to be passed from baby to mother. If a baby has thrush this will be on the tongue, lips, insides of the cheeks and spread rapidly. This presents as white patches that do not rub off.

 

Please note that just a white tongue alone can be milk residue from feeding or skin cells and if feeding is going well is not concerning.

 

Oral thrush quickly spreads to cover lips, inside cheeks etc. If the baby does have thrush the mother does not need to treat herself.

Further links:

Overdiagnosis and overtreatment of nipple and breast candidiasis: A review of the relationship between diagnoses of mammary candidiasis and Candida albicans in breastfeeding women

Yeast Infection While Breastfeeding? - Physician Guide to Breastfeeding