This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Pain associated with breast-feeding is second only to insufficient milk supply as the most common cause for early weaning. Candida infection of the breast has been postulated as one of the causes of breast-feeding associated pain. There is a paucity of data confirming this possible relationship. Persistent nipple pain (after the first two weeks) in lactating women, burning in nature and associated with radiating breast pain during and after feedings, has been linked to Candida infection of the breast. The physiological causes of the infection and treatment options are not well studied. Despite the lack of evidence, there is a growing body of lay literature recommending oral treatment of the nursing infant with nystatin and treatment of the mother with both topical antifungals (nystatin) and systemic antifungals (fluconazole). Our overall hypothesis is that pain associated with breast-feeding is not associated with the presence of Candida. The primary purpose of this research project is to determine the presence of Candida (and/or other pathogens) on the superficial breast (areolar, nipple) and within the ductal architecture in lactating women with and without symptoms breastfeeding-associated pain will also be determined.
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