Does this sound like thrush?

[MammaCici]

My 3.5 month old boy is exclusively bf. We haven't used antibiotics. He has had a persistent nappy rash that was mild and didn't bother him. The skin just felt rough around his anus. I showed his nurse 2 days ago and she suggested antifungal cream which we've been using along with a stricter nappy change rout

Oops, I hit the wrong botton...

I'll continue now...

We have a stricter nappy routine. He had the mild rash for a few weeks but since starting the new cream the rash is much more red, although it may be shrinking. That's what I'm hoping.
However I now suspect oral and nipple thrush also. Baby's roof of mouth has a mother of pearl appearance. I don't see any distinct white patches, just a gradual change of hue to whitish areas. My nipples feel hot and slightly itchy but aren't painful.
Does it sound like thrush and if so what should I do? I called the hospital's lactation consultant but they are gone for the weekend.

Also, for a few weeks now baby pulls on and off the breast. Occasionally he screams out like he's in pain when he feeds.