Brief overview
- Symptoms: Itching and burning at the nipples, possibly small blisters, reddish, shiny skin, small cracks at the nipple, pain during breastfeeding, possibly simultaneous symptoms of oral thrush or diaper thrush in the baby.
- Treatment: Ointments with antifungal agents (antimycotics) to be applied to the affected areas of the breast, simultaneous treatment of the breastfeeding baby, in case of persistent symptoms antimycotics to be taken by mouth.
- Course of disease and prognosis: With appropriate treatment, the symptoms disappear and the ability to breastfeed is maintained. More rare are persistent or recurrent courses.
- Causes and risk factors: Yeast infection, usually caused by the pathogen Candida albicans, transmission from baby (e.g., oral thrush or diaper thrush) to mother and vice versa possible, increased risk due to certain medications (e.g., antibiotics, cortisone).
How do I recognize breast thrush?
Often, the symptoms of breast thrush appear suddenly after a long, problem-free breastfeeding phase. Affected women then notice red, shiny and sometimes scaly areas on one or both nipples. In addition, the following symptoms occur with breast thrush:
- burning, itching nipples
- small cracks in the skin of the nipple or areola, if any
- reddish blisters, like a skin rash
- possibly whitish plaques
- possibly light-colored (depigmented skin areas)
Since the yeast fungi that cause breast thrush are contagious, symptoms sometimes appear in the baby as well. The signs can be seen in the infant’s mouth, for example, in the form of whitish coatings on the cheek mucosa or tongue. In this case, doctors speak of oral thrush.
Sometimes women with breast thrush notice signs of vaginal fungus at the same time.
How is breast thrush treated?
Breast thrush can be treated with antifungal drugs called antimycotics. Usually, the doctor prescribes an ointment to be applied to the affected areas for the treatment of breast thrush. Breastfeeding is still possible during the treatment of breast thrush.
When treating breast thrush, it is important that both the affected woman and the baby are treated. This is because the thrush on the nipple also reaches the baby during breastfeeding. Sometimes oral thrush exists in the baby unnoticed at first and the Candida fungi have infected the mother’s breast during breastfeeding.
Do home remedies help with breast thrush?
Basically, it is not recommended to treat thrush on the nipples with home remedies alone. There are no known home remedies that effectively combat an infection with Candida yeasts. Especially in babies, who often contract thrush at the same time as breastfeeding, the infection may spread further without treatment and sometimes affect the intestines.
Midwives sometimes advise applying a drop of breast milk to sore nipples as a home remedy. However, this does not apply to breast thrush; on the contrary, breast milk should not dry on the nipple.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.
How can breast thrush be prevented?
The following hygiene measures are useful in preventing breast thrush and protecting against re-infection:
- Careful hand hygiene: wash your hands before and after breastfeeding and changing the baby’s diaper, as well as your baby’s hands as part of your daily personal hygiene routine.
- Textile hygiene: Wash towels, washcloths, spit-up cloths and bras at 60 °C.
What do I need to keep in mind when breastfeeding?
In addition to the general hygiene measures to prevent thrush, it is also helpful to follow these tips around breastfeeding:
- If the doctor has diagnosed you with breast thrush, use disposable nursing pads. Change them frequently and especially immediately if they are wet.
- If you express breast milk, clean and sterilize all pump parts after each use, the same goes for other breastfeeding utensils such as nursing caps.
- After breastfeeding, wash the breast with warm water and let the skin air dry (if possible).
- Then apply the breast thrush ointment to the affected area. Do not squeeze the ointment directly from the tube onto the area on the breast: otherwise there is a risk of contaminating the tube with yeast fungi.
Breast thrush is not a reason to stop breastfeeding. You may continue to breastfeed your baby during treatment.
When does breast thrush get better?
Usually, the symptoms of a breast thrush infection do not last beyond the treatment period. Under proper treatment, symptoms usually improve and the breast thrush disappears. It is important that both the mother and the baby are treated for thrush to prevent re-infection of each other.
What is the cause of breast thrush?
The cause of breast thrush is an infestation of one or both nipples with a certain yeast fungus. Almost always, this is Candida albicans. Candida fungi occur in small numbers as normal inhabitants of the skin or mucous membrane.
In the case of breast thrush, the following risk factors are added:
- The warm, moist environment under breastfeeding pads provides ideal growth conditions for Candida albicans.
- Babies are more easily infected with thrush due to their immature immune system – sometimes they transmit oral thrush unnoticed to the mother during breastfeeding and thus cause breast thrush.
- Diaper thrush in infants is sometimes a source of infection for breast thrush and is transmitted, for example, if hand hygiene is inadequate.
In most cases, the midwife or doctor recognizes breast thrush on the basis of typical symptoms and appearance. If a baby has oral thrush or diaper thrush at the same time, breast thrush is also very likely.
In other forms of thrush, the doctor often detects the pathogen by taking a swab from the affected area. However, this is usually not successful in the case of breast thrush.
