If you spot blood while breastfeeding, see your GP. Blood could be a sign of an underlying infection, like mastitis or thrush, and you need to sort this out as soon as you can.

However, keep breastfeeding through mastitis or thrush as your baby relies on your milk supply. You must also keep the breast flushing through new milk to evict the infection.

Mastitis is inflammation of the breast. Most cases of mastitis happen in breastfeeding mothers, although it can also happen in women who are not breastfeeding. It is sometimes caused by an infection spreading from another part of the body, or when bacteria get into the breast through cracked or pierced nipples. Women aged between 18 and 50 are the most commonly affected. Usually mastitis is an acute condition, so it shouldn't take too long to cure.

Thrush

Thrush is a fungal infection in the baby's mouth that can spread to your breasts. It is also referred to as a yeast infection. Common signs of thrush are:

In the mother:

• Itchy, red, or burning nipples
• Deep, shooting breast pain during or after feeds
• Cracked nipples

In the baby:

• White patches in mouth that are not easily washed off
• Nappy rash

Causes of Thrush

Thrush is caused by the fungus Candida albicans. Everyone has this fungus in their body, it's a normal part of the digestive system and generally the bacteria keep it under control. Occasionally it grows and spreads, causing an infection. Thrush is common in breastfeeding mums as breastfeeding creates the perfect environment for thrush - a warm, moist, sugary environment, which is exactly what your baby's mouth is like during breastfeeding.

Thrush can also be triggered by eating sugary foods, taking antibiotics, getting inadequate rest, stress, allergies, and injury to the nipples from poor positioning.

Always contact your GP if you feel you have thrush, and they will be able to prescribe an antifungal medication. Thrush can take up to a few weeks to cure, and you and your baby need to be treated simultaneously. To avoid spreading the infection or re-infection, you should wash toys, dummies, and breast pump parts in boiling water after each use. Keep hands clean, especially after feeds, and keep nipples clean with warm water and dry them thoroughly. Thrush flourishes in damp conditions, so it is not advisable to use a nipple ointment under these circumstances.

How will my baby be affected?

Candida or a fungal infection on your nipples can be spread from mother to baby and the infection will be passed back and forth until treated. It is likely that your baby will have thrush if you do, even if you are not able to see any tiny white spots on the tongue or the inside of their mouth. Your baby will need treatment just as much as you do, or you may pass the infection back and forth.

The thrush infection may make the baby more unsettled than usual during feeds, or reluctant to feed because of a sore mouth. Some babies may not be bothered at all.

Should I still breastfeed?

Yes. Thrush shouldn't affect your ability to breastfeed your baby and you can continue throughout the course of your treatment.