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The yeast connection: is Candida linked to breastfeeding associated pain?

Andrews JI, Fleener DK, Messer SA, Hansen WF, Pfaller MA, Diekema DJ

Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

OBJECTIVE: The objective of the study was to determine whether the isolation of Candida from breastfeeding women is associated with self-reported pain. STUDY DESIGN: A prospective cohort study was conducted from May 2004 to July 2006. Ninety-eight breastfeeding women were enrolled: 20 women reported breastfeeding associated pain, and 78 women were asymptomatic. Cultures were obtained from breast milk, areolae, and infants' oropharynx. RESULTS: Six of the 20 symptomatic women had breast milk cultures positive for yeast, compared with 6 of 78 controls (30% vs 7.7%, P = .015). Among the 12 women from whom yeast was isolated, 11 grew Candida albicans. Incidence of Staphylococcus aureus isolation did not differ significantly between groups (5 of 20 vs 15 of 78, P > .05). CONCLUSION: C. albicans is found more often in breastfeeding mothers who report pain as compared with asymptomatic breastfeeding mothers. Further studies, including treatment trials, are needed to determine whether Candida plays an etiologic role in breastfeeding associated pain.

Published 1 October 2007 in Am J Obstet Gynecol, 197(4): 424.e1-4.
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