It is a fungal infection of the breast and/or nipple.
It affects approximately one third of women who experience pain during lactation.
Candida species are part of the normal healthy microbiota in the mouth, gastrointestinal tract and female genitourinary tract, so Candida can easily spread between parts of a woman's body, and between mother and baby.
It can cause burning nipple pain, usually in both breasts. In addition, the breast may appear diffusely pink, show satellite lesions or streaks radiating from the nipple. The skin may appear shiny and, after a few days, may become scaly. Symptoms tend to worsen during or immediately after breastfeeding.
When suspected, a thorough evaluation of breastfeeding, including posture and latch, should be performed, as trauma and maceration may predispose to candidiasis. The goal is to help mothers continue to breastfeed; to this end, artificially expressed breast milk is usually given to the infant, allowing the skin time to heal.
Topical antifungals are the first-line treatment, however some women require oral antifungals when deep breast pain does not improve with topical antifungals. Taking a probiotic can help restore a healthy microbiome.
- Amir LH, Donath SM, Garland SM, Tabrizi SN, Bennett CM, Cullinane M, Payne MS. Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia. BMJ Open. 2013 Mar 9;3(3):e002351. doi: 10.1136/bmjopen-2012-002351.
- Merad Y, Derrar H, Belkacemi M, Drici A, Belmokhtar Z. Candida albicans Mastitis in Breastfeeding Woman: An Under Recognized Diagnosis. Cureus. 2020 Dec 11;12(12):e12026. doi: 10.7759/cureus.12026
- Francis-Morrill J, Heinig MJ, Pappagianis D, Dewey KG. Diagnostic value of signs and symptoms of mammary candidosis among lactating women. J Hum Lact. 2004 Aug;20(3):288-95; quiz 296-9. doi: 10.1177/0890334404267226.
