Whether it’s your first time breast-feeding, or you’re breast-feeding your second or third child, you may be aware of some common problems.

Some infants have a hard time latching onto the nipple, and sometimes the flow of milk can be too slow or too fast. You may even prepare mentally for the possibility of sore nipples, but you might not expect itchy nipples caused by breast-feeding.

Itchy nipples while breast-feeding can be a sign of a yeast infection in you, or thrush in your baby’s mouth.

A yeast infection can affect the nipples and other parts of the body, including the mouth (where it is called thrush), genitals, and breast. You have a higher risk of developing this infection on your nipples if your baby has oral thrush. Common signs of nipple yeast infection include:

  • itchy or burning nipples
  • flaky nipples
  • cracked nipples
  • pain during breast-feeding
  • deep breast pain

Depending on the severity of the infection, your nipples may be sore to the touch. A bra, nightgown, or any other clothing that rubs against your nipples can cause pain. It’s also important to note that pain levels can vary. Some women have sharp, shooting pain in their nipples and breast, whereas other only have mild discomfort.

If you suspect a nipple yeast infection, check your baby for signs of a thrush infection. In the mouth, thrush appears as a white coating on the tongue and white spots on the inner lips. Your baby may also have raised white spots on the inside of the cheeks, or a red rash with spots in the diaper area.

Thrush can develop in anyone, but it commonly occurs in babies, the elderly, and people with a weaker immune system. This infection is caused by the Candida fungus, which is a type of organism that is found on the skin and mucous membranes. Your immune system will normally control the growth of this organism, but sometimes there’s an overgrowth of yeast.

Different diseases can contribute to the overgrowth, like diabetes and cancer. Also, taking an antibiotic or the drug prednisone (a corticosteroid) can affect the natural balance of microorganisms in your body. This change increases the likelihood of developing a yeast infection.

If a mother has a vaginal yeast infection at the time of delivery, a baby can be exposed to the infection as it passes through the birth canal. Additionally, if you take antibiotics after delivering your baby, the medication can seep into your breast milk. This can disturb microorganisms in your body and cause thrush in your baby.

Although thrush is a harmless infection, it’s important to seek medical attention if you notice thrush while breast-feeding, or if you suspect the infection in your baby. If left untreated, you and your baby can pass the infection back and forth during breast-feeding.

To treat the infection in your baby, your doctor may prescribe a mild anti-fungal medication. You will also be given an anti-fungal to apply to your nipples and breasts. These medications come in tablet, liquid, or cream form. In addition to the anti-fungal, your doctor may recommend a pain medicine to reduce inflammation and breast pain, such as ibuprofen.

Thrush can be hard to treat. It’s important to follow your doctor’s instructions and take or apply the medication as directed. The length of treatment depends on the level of the infection. To help clear the infection faster or avoid reinfection, make sure you boil pacifiers or bottle nipples used by your baby for at least 20 minutes a day. You should also replace these items every week. All of your baby’s mouth toys should be cleaned with hot, soapy water.

In addition to prescription and over-the-counter medications to treat itchy nipple thrush, you can also take other precautions to improve your condition. Make sure you wash your bras and nightgowns with bleach and hot water. You can use a nursing pad to prevent your nipples from touching your clothes, which can help stop the spread of the fungus.

Yeast like warm, moist environments. Allowing your skin to air-dry before putting your bra back on after breast-feeding will help avoid yeast infection.

While itchiness and pain caused by a yeast infection is a common problem linked to breast-feeding, it’s important that you speak with your doctor to receive an accurate diagnosis.

Itchy, scaly, and painful nipples can also be a sign of skin eczema or dermatitis. In most cases, doctors can diagnose thrush by simply looking at the breasts. After you’re diagnosed, call your doctor if the infection doesn’t clear up after treatment, or if your condition worsens.