Occasionally, a breastfeeding mother will experience sore nipples after a period of pain-free nursing. If all other causes have been ruled out, such as improper positioning and inadequate latch-on, thrush should be considered.

Thrush is a common yeast infection that affects the mucous membranes. Yeast is normally present in the body in harmless amounts, but an overgrowth can occur under a variety of circumstances. The organism thrives on the lactose in milk – be it human or bovine – and thrush can be a problem in a formula-fed baby as well.

A yeast infection in a premature or low-birth-weight infant can be life-threatening, as can a yeast infection in an individual whose immune system is impaired by other illness or infection. Luckily, for most people, thrush is not a serious condition and breastfeeding can and should continue.

Symptoms in the mother that may cause thrush to be considered are itchy, "burning" nipples, "shooting" pains during or after a feeding, bright pink nipples extending into the areola (where baby's mouth touches) or "flaky" nipple skin. Mother may also have symptoms of a vaginal yeast infection.

Signs of yeast infection in the breastfed infant may include a sudden onset of fussiness at the breast, including pulling off the breast during a feeding, gassiness or colic symptoms and, occasionally, slow weight gain. Baby may or may not have white spots or a film inside the mouth, on the gums or on the tongue.

The baby also may have a diaper rash with raised, patchy areas or a shiny appearance. Sometimes, the baby may refuse to nurse or pull off the breast repeatedly during a feeding. In rare cases, feedings may be interrupted by Baby's discomfort, which could result in inadequate weight gain. However, it is possible for thrush to be present even without any visible symptoms on Mother or Baby.

Mothers who are susceptible to vaginal yeast infections, have recently used antibiotics or have a history of diabetes (gestational or insulin-dependent) are more likely to harbor yeast in their bodies. A history of anemia, use of steroid medications such as those used to suppress preterm labor, use of antidepressant medications or the use of oral contraceptives can also contribute to the possible invasion of yeast.

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