Candida (yeast) infections of the nipple and ducts
Candida infections of the nipples may occur any time while the mother is breastfeeding. Candida albicans likes warm, moist, dark areas. It lives normally on us, and 90% of babies are colonised by it within a few hours of birth. It only becomes a problem under certain circumstances.
Candida infections of the skin or mucous membranes are more likely to occur when there is a breakdown in the integrity of the skin or mucous membrane—another reason why a good latch is very important from the very first day. Many Candida infections would, perhaps, not have occurred, if the mother had not had sore nipples and a breakdown of the skin of the nipples and areola. The oozing of serum which occurs often in cracked nipples turns Candida albicans from its harmless form to a disease causing form.
The widespread use of antibiotics also encourages the overgrowth of Candida albicans. Many pregnant women, women in labour, and new mothers, as well as their babies receive antibiotics, sometimes with very little justification.
Diagnosis of Candida infections of the nipples and/or ducts
There is no good test which helps makes the diagnosis. A positive culture from the nipple(s) proves little. Neither does a negative culture. The best way to make a diagnosis is by history.
The presence or absence of a Candida infection in the baby is not helpful. A baby may have thrush all over his mouth, but the mother have no pain. A mother may have the classic symptoms of a Candida infection of the nipples, and the baby have no thrush or diaper rash.
The typical symptoms of a Candida infection of the nipples are:
- Nipple pain which begins after a period of pain free nursing. Though there are a few other causes of nipple pain which begin later, Candida infection is definitely the most common. The nipple pain of Candida may begin without an interval of pain free nursing, however.
- Burning nipple pain which continues throughout the feeding, sometimes continuing after the feeding is over.
- Pain in the breast which is "shooting" or "burning" in nature and which goes through to the mother's back and shoulder. This pain is usually worse toward the end of the feeding, and worsens still more after the feeding is over. It also tends to be much worse at night. This pain may occur without any nipple pain.
- Pain, as above, which is made much better with the use of gentian violet.
