Oral thrush is a fungal infection in your mouth. Healthy babies under two years old often get oral thrush. It's most common in babies around four weeks old.
If your baby has oral thrush and you're breastfeeding, it's possible for your baby to pass a thrush infection to you. The infection can affect your nipples or breasts. It's commonly called nipple thrush (mammary candidosis or mammary candidiasis).
The symptoms of nipple thrush can include:
It's also possible that you may have no symptoms of infection.
Symptoms of nipple thrush do not include fever or redness of your breasts. However, these can be symptoms of mastitis (inflammation of the breast).
A nipple thrush infection is difficult to diagnose, because you may have no symptoms, even if it's confirmed that your baby has oral thrush and some of your symptoms can also be found in other conditions. For example, pain in your nipples could also be caused by a bacterial infection.
If your nipples are sore, painful or cracked, the most likely cause is that your baby is not attached to your breast correctly when feeding. See breastfeeding positioning and attachment for more information about how to correctly breastfeed your baby.
If you have no symptoms, you're unlikely to need treatment, even if it's confirmed that your baby has oral thrush.
If you do have symptoms or if the infection is causing problems with feeding, your GP may prescribe an antifungal cream such as miconazole, which is usually used for two weeks. You should apply the cream to your nipples after every feed and remove any that's left before you feed your baby again.
If your infection is more severe – for example, the infection can go deeper into your breasts and spread to your milk ducts – your GP may recommend a course of antifungal tablets, such as nystatin.
If your GP prescribes antifungal cream or tablets for you, your baby will probably be treated at the same time to prevent reinfection. If your baby is prescribed miconazole gel, the dosage will vary, depending on your baby's age.
Your GP will be able to recommend the correct dosage for your baby and advise you about how long the treatment is needed. Read more about treating oral thrush in babies.
If the infection does not clear up after a few days or if feeding problems continue, you should visit your GP again.
If you think you have nipple thrush or mastitis, you should seek advice from your midwife, health visitor or GP.
A breastfeeding counsellor may be able to provide specialist advice about feeding problems. You can also ask your midwife, health visitor or GP for advice about feeding your baby, or you can call NHS 111.