Thrush during pregnancy and breastfeeding

Thrush is an infection caused by a yeast called candida. It is also commonly known as a yeast infection.

It usually affects the vagina and vulva (external part of the female genitalia) but can also affect your mouth, breasts or nipples.

If you're breastfeeding and have thrush on your breasts or nipples, your baby may get it too. They can develop thrush in their mouth or on their bottom.

Thrush can cause different symptoms depending on where it is in your body. Both vaginal thrush and breast or nipple thrush can cause itching, pain and redness.

Vaginal thrush

If you have vaginal thrush, you may have:

• itching or pain in your vagina or vulva
• redness and swelling in the area
• pain when you wee or have sex
• white discharge that may look like cottage cheese
• splits in the skin of your vulva

Breast and nipple thrush

The most common symptom is pain in your nipples or breasts.

Breast thrush symptoms include:

• shooting or stabbing pain deep in one or both breasts
• a burning sensation that spreads through your breast
• pain immediately after feeding and in between feeds

Nipple thrush symptoms include:

• itching or burning pain
• sensitive nipples
• pink and shiny nipples with a red, dry or flaky areola (the coloured area around your nipple)
• nipple cracks or damage that is slow to heal

Pain from nipple thrush doesn't go away with better positioning or attachment of your baby to your breast.

If you have breast or nipple thrush, your baby may also have thrush. They may have a white coating on their tongue or inside their cheeks, and a red nappy rash with small dots.

Thrush is caused by having too much yeast (candida) that normally lives in your vagina or gut.

Vaginal thrush

Thrush in the vagina can happen when there is an imbalance of candida in your vagina. This may happen after you take antibiotics, which kill the bacteria that control yeast.

Breast and nipple thrush

Candida can also live on your skin. It grows in warm, damp conditions, such as your nipple area if you're breastfeeding. If there are cracks in your nipple, the yeast can get inside and cause thrush.

You're more likely to get nipple thrush if you have recently taken antibiotics (Opens in new tab) or had vaginal thrush. However, often there isn't a clear cause.

Am I more likely to get thrush during pregnancy?

If you're pregnant, you are twice as likely to get vaginal thrush. This is because you have more of the hormone oestrogen in your body while you are pregnant. High levels of oestrogen (Opens in new tab) can help candida grow. Oestrogen naturally raises the sugar level in your vagina, which helps yeast grow.

See your doctor if you think you may have thrush or if:

• it's your first time experiencing thrush-like symptoms
• your symptoms continue after treatment
• you continue to have painful sex after treatment
• you get thrush frequently
• you feel pain in your pelvic or vulval area
• you have unusual vaginal bleeding

Other conditions, such as genital herpes (Opens in new tab) or urinary tract (Opens in new tab) infection, can have similar symptoms. So it is important to see your doctor.

Vaginal thrush during pregnancy will not harm your baby. If you have thrush during labour and birth, there's a chance you can pass it to your baby. If this happens, it is easy to treat.

Vaginal thrush does not usually cause long-term health problems or risks to your fertility or pregnancy.

You can use antifungal vaginal creams or pessaries (tablets that you insert in your vagina) to treat thrush during pregnancy. These contain the medicines clotrimazole (Opens in new tab) or nystatin (Opens in new tab), which are safe in pregnancy.

A 6-day course of treatment is better than shorter courses. Don't use the single dose oral tablet for thrush during pregnancy unless your doctor tells you to.

If you're using pessaries, it's best not to use the applicator.

Even though these medicines are available without a prescription, it's best to see your doctor first. This is to make sure there's nothing else causing your symptoms.

Speak to your doctor or pharmacist before using any medicine.

Treatments for thrush while breastfeeding differ slightly depending on whether you have vaginal thrush or breast and nipple thrush.

Vaginal thrush

Your doctor may prescribe you antifungal creams (Opens in new tab) or pessaries for vaginal thrush. If you have vaginal thrush when you're breastfeeding, you can use the same treatment as when you are pregnant.

It's best to see your doctor and talk to your pharmacist before starting treatment.

Breast and nipple thrush

If you have nipple thrush, both you and your baby need treatment at the same time. This is so you don't keep giving the infection to each other.

Your baby will usually be prescribed miconazole oral gel. After feeds, wash your hands and rub a small amount of gel onto your baby's tongue and on the inside of their cheeks. Ask your doctor or pharmacist how to use the gel safely. Nystatin drops are another option, but they are less effective. If your baby has nappy rash, they may also need an antifungal cream.

You can treat your nipples with miconazole oral gel or nystatin cream. Apply a thin layer to both nipples after feeds. You don't need to wipe it off before the next feed. Your doctor may also prescribe oral antifungal tablets for you.

Ask your doctor how long to use each treatment. If your pain doesn't improve, you may need a different medicine.

Can I keep breastfeeding my baby?

Yes, if you have vaginal or nipple thrush, it's safe to breastfeed. You don't need to throw out expressed breastmilk.

Tips to prevent thrush include:

• Wear cotton underwear and loose clothing.
• Wipe from front to back and wash your hands when you go to the toilet.
• Don't use soap or scented products in your vulval area.
• Wash your hands after changing nappies.
• Sterilise bottle teats and dummies every day.
• Change your breast pads often.
• Wash your bras and towels in hot water and hang them out to dry.

Some people find that taking a probiotic can help to control repeated thrush infections. Taking a probiotic may also be suggested if you are taking antibiotics. Speak to your doctor or pharmacist for more advice about probiotics, and if this is right for you.

The Royal Women's Hospital offers fact sheets on:

• breast and nipple thrush (Opens in new tab)
• medicines in pregnancy (Opens in new tab)
• medicines in breastfeeding (Opens in new tab)

Do you prefer to read in languages other than English?

SA Health (Opens in new tab) offers information on thrush in various languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

You can find out more about Aboriginal and/or Torres Strait Islander pregnancy health on Stronger Bubba Born (Opens in new tab) or watch the How to Have a Safer Pregnancy (Opens in new tab) video.

Australian Breastfeeding Association (Opens in new tab) offers breastfeeding resources for Aboriginal and/or Torres Strait Islander families.