Risk Factors for Mammary Candidosis Among Lactating Women

Authors

  • Jimi Francis Morrill,

    Corresponding author
    1. Jimi Francis Morrill, PhD, is a member of the research faculty at the Allie M. Lee Laboratory for Cancer Research, and is in the Department of Biochemistry at the University of Nevada-Reno.
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  • M. Jane Heinig,

    1. M. Jane Heinig, PhD, is an academic administrator at the Human Lactation Center in the Department of Nutrition, University of California, Davis.
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  • Demosthenes Pappagianis,

    1. Demosthenes Pappagianis, MD, PhD, is a professor in the Department of Medical Microbiology and Immunology at the School of Medicine, University of California, Davis.
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  • Kathryn G. Dewey

    1. Kathryn G. Dewey, PhD, is a professor in the Department of Nutrition at the University of California, Davis.
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Address for correspondence: Jimi Francis Morrill, PhD, Department of Biochemistry, University of Nevada-Reno, Reno, NV 89557. E-mail: jfrancis@unr.edu.

Abstract

Objectives: To document the occurrence of Candida colonization and mammary candidosis among lactating women, risk factors for Candida colonization, and the relationship between Candida colonization and breastfeeding at 9 weeks postpartum.

Design: Prospective cohort study.

Setting: Private practice clinic in Reno, Nevada.

Participants: 100 lactating women and their infants, and 40 nonpregnant, nonlactating women (controls).

Procedure: At 2 weeks postpartum, skin and milk samples were collected from the lactating women and oral samples were collected from their infants. Skin samples were collected from control subjects. All samples were cultured for Candida species. Lactating women were recontacted by phone at 9 weeks postpartum to assess infant feeding practices.

Main Outcome Measure: Colonization with Candida species.

Results: None of the control subjects tested positive for Candida colonization. Of the lactating women, 23% tested positive for Candida and 20% had mammary candidosis. Risk factors for colonization of the mother were bottle use in the first 2 weeks postpartum and pregnancy duration of > 40 weeks. Of the 100 infants, 20% tested positive for Candida. Risk factors for colonization of the infant were bottle use in the first 2 weeks postpartum and presence of siblings. Among women who tested positive at 2 weeks, 43% were still breastfeeding at 9 weeks postpartum compared to 69% of the women who did not test positive (p < .05).

Conclusion: Avoidance of bottle use early postpartum may reduce the risk of mammary candidosis. Mammary candidosis is related to early termination of breastfeeding.

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