Nipple pain, mastalgia and candidiasis in the lactating breast

During lactation, persistently sore nipples or shooting breast pain in the absence of local or systemic signs may be symptoms of C. albicans infection of the nipples and/or breast ducts. The nipple may be erythematous or fissured, but the appearance does not resemble oral or vaginal candidiasis. Case 1 is a woman with sore nipples following a course of antibiotics. Case 2 is a woman with severe shooting breast pain which was worsened by antibiotic treatment. Treatment included topical and oral antifungal treatment for the mother in conjunction with an 'anti-candida' diet. The infant's mouth was also treated to prevent reinfection.