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Diagnostic Value of Signs and Symptoms of Mammary Candidosis among Lactating Women

Department of Nutrition, University of California, Davis

M. Jane Heinig, PhD IBCLC

UC Davis Human Lactation Center, Department of Nutrition, University of California, Davis

Demosthenes Pappagianis, MD PhD

Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis

Kathryn G. Dewey, PhD

Department of Nutrition, University of California, Davis

Mammary candidosis in lactating women is not well defined and is most often presumptively diagnosed by signs and symptoms. This study evaluates the sensitivity, specificity, positive predictive value, and likelihood ratios of signs and symptoms of mammary candidosis based on the presence of Candida species on the nipple/areola or in the milk. In this prospective cohort study, the nipple/areola skin and milk of 100 healthy breastfeeding mothers were cultured from each breast at 2 weeks postpartum, and mothers were interviewed regarding signs and symptoms associated with mammary candidosis between 2 and 9 weeks postpartum. Positive predictive value for Candida colonization was highest when there were 3 or more signs or symptoms simultaneously or when flaky or shiny skin of the nipple/areola was reported together or in combination with breast pain. J Hum Lact. 20(3):288-295.

Key Words: mammary candidosis • Candida albicans • nipple pain • breast pain • diagnosis • signs • symptoms • breastfeeding

Journal of Human Lactation, Vol. 20, No. 3, 288-295 (2004)
DOI: 10.1177/0890334404267226


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