Candidal infection of the breast is a controversial topic and practitioners are divided in their opinions.
However, clinical breastfeeding medical specialists recommend that candidal infections of the nipples and breast should be considered when a lactating woman, who has mastitis, develops what has been classified as the classic symptoms of candida.
It is difficult to obtain a positive culture for candida from a breast milk sample.
There may be a history of antibiotic treatment in pregnancy or during labour.
Typical symptoms
Typical symptoms are:
- Burning nipple pain
- Pain radiating through the breast
- Stinging sensation in the nipples and breast.
Signs
- There may be no obvious signs although the nipple and areola may sometimes have a shiny appearance.
- White patches may be seen but this is rare.
- The baby may or may not have signs of oral and nappy-area thrush infection.
Treatment
- Antifungal treatment for both the mother and baby.
- Topical application to the nipples and also to the baby’s mouth and nappy area if necessary (Nystatin).
- Systemic treatment of the woman may be necessary and fluconazole is used by medical breastfeeding specialists ( Lawrence & Lawrence; Newman; Academy of Breastfeeding Medicine).
- Some practitioners recommend taking care with clothing that comes into contact with infected areas and recommend washing these items daily.
- Support continued breastfeeding and ensure the latching and positioning for breastfeeding are optimal.
