| Symptoms | Cause |
| Creamy white patches in Baby’s mouth, on tongue, gums, Inside of lips, which do not rub off. | Oral Thrush |
| Red, fiery, shiny sore nipples, Creamy white patches on nipple skin. Sore nipples that do not heal when Attachment is correct. | Topical Thrush |
| Intense pain during and between feeds, lasting up to an hour after feeds. Pain may shoot through breast. Nipple may be itchy or super sensitive to touch. | Systemic thrush in the breast |
What to do
Firstly, it is important to keep feeding and if you are using breast pads – try to ensure you are frequently changing them and using disposable pads while the thrush is present. Nursing bras should be changed frequently, hot washed and line or tumble-dried.
Thrush is often over-diagnosed, but most commonly develops if the mother is already prone to frequent bouts of vaginal thrush, and if mother and/or baby have been treated with antibiotics since the birth. Many women develop thrush after bouts of mastitis, especially if the mastitis is recurrent and has been treated with several lots of antibiotics. Check the positioning and attachment really carefully as the thrush may not be the only problem.
Treatment
Thrush in on the nipple must be topically treated. Mother and baby should both be treated, even if symptoms are only apparent in one. Treatment may be prescribed Daktarin cream for mother. Daktarin Oral Gel used to be prescribed for babies with thrush in their mouth but this is now under review. The Breastfeeding Network have information on this change and you can read more on their site. BfN Thrush Information
If thrush deep in the breast is suspected, this may be treated by oral antifungal agents; these must be prescribed by a doctor – guidance re: dosage etc. is available from the Breastfeeding Network (www.breastfeedingnetwork.org.uk). A leaflet and other information on thrush for mothers, with other tips and suggestions, are available from this website and many women find it really helpful.
This information has been compiled by Cornwall Midwives as part of the UNICEF training pack for health professionals. Thank you to them for allowing Real Baby Milk to use them on www.realbabymilk.org
Updated Jan 2009