I wonder how many cases of deep seated breast pain are mistakenly diagnosed
as thrush.
In my experience most mothers with this problem develop it because the baby
for some reason has changed its positioning at the breast. Thrush in the
baby's mouth is a major cause, as the baby finds it uncomfortable to feed,
so takes less breast in his/her mouth. Other causes are when the mother
becomes confident with her breastfeeding she often relaxes with
positioning,resulting in the baby not being so well attached. Also the older
baby can play around on the breast, spending quite a bit of it's time
suckling just on the nipple. This poor positioning can result in referred
pain that can last for several hours after feeding.
Thrush must be very clever to travel up the milk ducts in an anti-thrush
environment.
I always check the baby for thrush and ask the mother about the shape of her
nipple after feeding. The nipples will often be ridged. I also ask if the
tip of the nipple turns white 5 mins after feeding. If any of the answers
are "yes"
we then go over positioning. More often than not, that fixes the problem.

What evidence is there that thrush gets into the ducts? It must be very
clever to travel up the milk ducts against the flow, in an anti thrush
environment.
Regards
Robyn Dunning