title: The yeast connection: is Candida linked to breastfeeding associated pain?
abstract: OBJECTIVE
  The objective of the study was to determine whether the isolation of Candida from breastfeeding women is associated with self-reported pain.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors: Janet I
authors: JI
authors: Andrews
authors: Diedre K
authors: DK
authors: Fleener
authors: Shawn A
authors: SA
authors: Messer
authors: Wendy F
authors: WF
authors: Hansen
authors: Michael A
authors: MA
authors: Pfaller
authors: Daniel J
authors: DJ
authors: Diekema
mesh_terms: D000328:Adult; D001941:Breast Diseases / Q000150:complications* / Q000382:microbiology* / Q000473:pathology; D001942:Breast Feeding; D002176:Candida albicans / Q000254:growth & development*; D002179:Candidiasis, Cutaneous / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008895:Milk, Human / Q000382:microbiology; D010146:Pain / Q000209:etiology / Q000382:microbiology* / Q000473:pathology; D011446:Prospective Studies; D018709:Statistics, Nonparametric