Risk factors for mammary candidosis among lactating women.
OBJECTIVE
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.


METHODS
Prospective cohort study.


METHODS
Private practice clinic in Reno, Nevada.


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


METHODS
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.


METHODS
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).


CONCLUSIONS
Avoidance of bottle use early postpartum may reduce the risk of mammary candidosis. Mammary candidosis is related to early termination of breastfeeding.
Morrill
Jimi Francis
JF
Department of Biochemistry, University of Nevada-Reno, Reno, NV 89557, USA. jfrancis@unr.edu
Heinig
M Jane
MJ
Pappagianis
Demosthenes
D
Dewey
Kathryn G
KG
D000293:Adolescent; D000328:Adult; D001903:Bottle Feeding; D001942:Breast Feeding / Q000009:adverse effects*; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D015169:Colony Count, Microbial; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D007774:Lactation; D042361:Mammary Glands, Human / Q000382:microbiology; D009505:Nevada / Q000453:epidemiology; D010298:Parity; D049590:Postpartum Period; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014886:Weaning