Fungal infection of the breast and/or nipple.
It affects about a third of women who experience pain during breastfeeding.
Some types of candidiasis are part of the normal and healthy microbiota of the mouth, gastrointestinal tract and female genitourinary tract. This means that candidiasis can easily move between different parts of a woman's body, and also between mother and baby.
It can cause sore nipples, usually in both breasts. The breast may also appear slightly pink, with satellite lesions or stretch marks surrounding the nipple. The skin may be shiny and start to peel after a few days. Symptoms tend to get worse during or immediately after breastfeeding.
If suspected, a complete assessment of the mother's lactation should be carried out, including posture and grip, as trauma and maceration can predispose to candidiasis. The aim is to help mothers to continue to breastfeed as well as possible, and this is usually done by giving the baby artificially extracted breast milk to allow the skin to heal completely.
Topical antifungals are a first-line treatment, although some women need oral antifungals if the severe breast pain doesn't improve with topical antifungals alone. Taking some probiotics may help to restore a healthy microbiota.
- 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.
