Thrush

Thrush can sometimes occur if you or your baby are taking antibiotics and if there has been any damage to the nipple. However, thrush can occur at any time. If you suspect you or your baby may have thrush please speak to your Midwife, Health Visitor, Peer Supporter or GP for further advice and possible treatment.

Signs for you

• Sudden onset of breast/nipple pain after days/weeks of pain free breastfeeding
• Itchy nipple
• Highly sensitive nipple to any touch
• Cracked nipples that don’t heal
• Shooting pains in the breast after feeding that can last up to an hour
• Loss of colour in the nipple or areola
• Pain in both breasts as baby transfers it during feeding (not in early stages)

Signs for your baby

• Creamy, white patches in the mouth/tongue/cheeks that won’t rub off
• White sheen on the tongue/lips
• Baby keeps pulling off or away from breast while feeding and appears unhappy due to a sore mouth
• Windy and hard to settle
• Sore bottom which is usually red and spotty and doesn’t heal with regular nappy cream

Treatment

Mum and baby should be treated simultaneously for the treatment to be effective.

For you

You will probably be prescribed Miconazole cream, which should be applied in small amounts to the nipple after each feed. Wipe, not wash off, any excess prior to next feed. You may need to take some pain relief,  e.g. Paracetamol. Let your GP know if the pain is severe.

For your baby

Babies under four months will usually be prescribed Nystatin suspension, which needs to coat the baby’s mouth and not just the tongue for it to be effective, at least four times daily. Babies over four months old will usually be prescribed Miconazole oral gel, which is a more effective treatment, it is not given to younger babies because of the risk of choking.

General Advice

• Careful hand hygiene and good sterilisation of teats/toys, etc.
• To prevent reoccurrence, ensure the treatment is continued for the recommended time and not just until the symptoms disappear

Symptoms should begin to improve after 2-3 days. If there is no sign of improvement after this time, please consult your Midwife, Health Visitor or GP.

Breastfeeding Network (2009)