Occasionally, a nipple crack may hide a candidiasis infection, or mucosal-skin infection caused by fungus belonging of the genus Candida, the most common of which is the Candida Albicans.

Signs of Candida fungal infection:

  • Presence of thrush or diaper rash in the baby.
  • Maternal Candida vaginitis.
  • Prolonged use of antibiotics in the mother after caesarean.
  • Sudden onset of sore nipples after breastfeeding without problems.
  • Failure of cracks to heal even after correcting the way the baby latches on to the breast.
  • Persistence of pain even at rest between a feed and the other.
  • Salmon colored nipple lesions.

In the case of Candida infection, the possible sources of recontamination should be kept in mind:

  • Pacifiers and baby bottles, to be sterilized
  • The mother’s partner, who will have to undergo drug treatment.

If the pain does not allow the mother to tolerate the baby’s sucking, it is necessary to stop breast feeding until the cracks heals and give the baby pumped milk (preferably with a glass to interfere as little as possible with sucking of the breast). Candidiasis is the only case in which the application of a topical medication to the nipple is indicated. It should be applied for seven days after feedings, on both nipples and areolas, the miconazole gel or Nystatin suspension to both nipples, as well as treating any Candida infection in the mother and child. In case of failure, due to the probable infection along the lactiferous ducts, identified by more intense breast pain at the start of the feeding of the nipple, the mother will have to undergo systemic treatment suitable to the case.