ArticleBMJ open2013
Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 85 citations in OpenAlex.
- ABM clinical protocol #4: Mastitis, revised March 2014.Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine · 2014Guideline
- Trial
- Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations.Revista brasileira de enfermagem · 2023Trial
- A Framework for Evaluation of New Processing Technologies in Human Milk Banking.Comprehensive reviews in food science and food safety · 2025Review
- Exploring human milk oligosaccharides: mechanisms linking gut function to cognitive development in human and pig physiology.Frontiers in nutrition · 2025Review
- Pain Management for Postpartum Pain: A Narrative Review.Journal of pain research · 2025Review
- Nipple candidiasis and painful lactation: an updated overview.Postepy dermatologii i alergologii · 2022Review
- Random amplified polymorphic DNA analysis reveals no clear link between Staphylococcus epidermidis and acute mastitis.The Australian & New Zealand journal of obstetrics & gynaecology · 2022Article
- Human milk microbiota: what did we learn in the last 20 years?Microbiome research reports · 2022Review
- New perspectives on the topical management of recurrent candidiasis.Drug delivery and translational research · 2021Review
- Human Milk Microbiota and Oligosaccharides: A Glimpse into Benefits, Diversity, and Correlations.Nutrients · 2021Review
- Breast Milk: A Meal Worth Having.Frontiers in nutrition · 2021Review
- Human milk fungi: environmental determinants and inter-kingdom associations with milk bacteria in the CHILD Cohort Study.BMC microbiology · 2020Article
- Emerging Perspectives on Pain Management by Modulation of TRP Channels and ANO1.International journal of molecular sciences · 2019Review
- Article
- The ATP Transporter VNUT Mediates Induction of Dectin-1-Triggered Candida Nociception.iScience · 2018Article
- Deep breast pain during lactation: a case-control study in Sweden investigating the role ofInternational breastfeeding journal · 2018Article
- Multiple Approaches Detect the Presence of Fungi in Human Breastmilk Samples from Healthy Mothers.Scientific reports · 2017Article
- Article
- Mammary candidiasis: molecular-based detection of Candida species in human milk samples.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate Candida species and Staphylococcus aureus and the development of 'nipple and breast thrush' among breastfeeding women.
designProspective longitudinal cohort study.
settingTwo hospitals in Melbourne, Australia (one public, one private) with follow-up in the community.
participants360 nulliparous women recruited at ≥36 weeks' gestation from November 2009 to June 2011. Participants were followed up six times: in hospital, at home weekly until 4 weeks postpartum and by telephone at 8 weeks.
main outcome measuresCase definition 'nipple and breast thrush': burning nipple pain and breast pain (not related to mastitis); detection of Candida spp (using culture and PCR) in the mother's vagina, nipple or breast milk or in the baby's mouth; detection of S aureus in the mother's nipple or breast milk.
resultsWomen with the case definition of nipple/breast thrush were more likely to have Candida spp in nipple/breast milk/baby oral samples (54%) compared to other women (36%, p=0.014). S aureus was common in nipple/breast milk/baby samples of women with these symptoms as well as women without these symptoms (82% vs 79%) (p=0.597). Time-to-event analysis examined predictors of nipple/breast thrush up to and including the time of data collection. Candida in nipple/breast milk/baby predicted incidence of the case definition (rate ratio (RR) 1.87 (95% CI 1.10 to 3.16, p=0.018). We do not have evidence that S aureus colonisation was a predictor of these symptoms (RR 1.53, 95% CI 0.88 to 2.64, p=0.13). Nipple damage was also a predictor of these symptoms, RR 2.30 (95% CI 1.19 to 4.43, p=0.012). In the multivariate model, with all three predictors, the RRs were very similar to the univariate RRs. This indicates that Candida and nipple damage are independent predictors of our case definition.
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Registered trials
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