It’s usually NOT Thrush

Written By elisabeth cox

Nipple thrush is hugely over diagnosed. Any breastfeeding person with red, sore nipples, or sharp shooting breast pain is diagnosed with Thrush, often without a breastfeeding examination. Prescriptions for long, multi-drug treatments are handed out, and often symptoms improve or resolve, only to recur quickly on stopping the medication.

This is because we haven’t fixed the cause of the pain, which is usually from latching issues. We shouldn’t be prescribing these medictions without a breastfeeding assessment, or a referral for a breastfeeding assessment. Recurrent or persisten Thrush can occur, but it is uncommon.

What is Thrush?

Thrush is a fungal infection caused by Candida. Candida exists on our skin and in our mouths at low levels and doesn’t cause issues. In certain circumstances, Candida can overgrow which can lead to inflammation, causing pain, redness, swelling, skin breakdown and discharge. Risk factors for Thrush Include antibiotic use, immunosuppression and diabetes.

Symptoms of Nipple Thrush

  • Red, swollen nipple or areola

  • Flaking skin

  • Itching

  • Buring

  • Sharp shooting pain

BUT…these symptoms are non-specific. They could be from any number of breast conditions, not just Thrush.

It all comes down to LATCH!

90% of breastfeeding issues come down to latch. If you have nipple trauma, your pain is latch related until proven otherwise. If you have pain on initial latch that eases quickly, your pain is latch related until proven otherwise. If it is significantly more comfortable to pump than breastfeed, your pain is latch related until proven otherswise!

Medication is not the answer

While medication may be indicated, without breastfeeding support your symptoms are likely to recur quickly.

Author: Dr Amber Hart
International Board Certified Lactation Consultant

elisabeth cox
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Edition 3 | May 2026