Microorganisms in vaginal fluid from women in prolonged pregnancy

Risk Factors for Mammary Candidosis Among Lactating Women

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.