Although yeast can be cultured in a lab, it is often too expensive and too slow to wait for results to begin treatment. Going to a lactation consultant or an experienced healthcare provider would be the best first step in diagnosing thrush. Since painful nipples are often the first sign a mom will notice, it is critical to rule out improper latching as the cause. Pain usually starts at the nipple and eventually begins to create a shooting, burning pain deep into the breast. This pain usually occurs toward the end of the feeding and in fact can occur even when not nursing. Nipples may appear very pink or red and progress to have white patches or tiny blisters on the nipple itself. Babies can present white patches on the tongue, cheeks, and gums and the lips may have a white sheen to them. Babies can also have a red or very pink diaper rash with or without red or white bumps that spread from the diaper to the genital area. Babies can also suddenly appear very fussy at the breast and want to get on and off throughout the feeding. It is important to note that either mom or baby OR both mom and baby may have thrush and the key to eradicating it completely is to treat both at the same time.