title: Risk factors for mammary candidosis among lactating women.
abstract: 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.
authors.affiliation: Department of Biochemistry, University of Nevada-Reno, Reno, NV 89557, USA. jfrancis@unr.edu
authors.forename: Jimi Francis
authors.initials: JF
authors.lastname: Morrill
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Heinig
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Pappagianis
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dewey
mesh_terms: 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