<<I wonder if this could be a form of dermatitis rather than yeast. It seems
that most of the yeast we see is in mothers who have directly breastfed and thus
have a source of infection ? via baby's mouth. It seems a little strange
that this mother has yeast if all she has done is pump.>>

Although most nipple thrush is passed from baby's mouth to mother's breast, it
is possible to have nipple thrush present at birth.  I have pictures of visible
yeast on the nipple and areola at 2 days postpartum from one of the moms I've
seen.  I've assumed that the route of transmission is probably from  infected
vagina via dad's hand during sex play.  The yeast on the nipples seems to not
cause a problem until you have a baby (or a pump) sucking on them.  A couple of
times the first clue to the presumed yeast was a pumping mother who had pain
even with the pump pressure set on minimum.  When treated with an antifungal
cream, the mother was able to turn the suction up.

It may very well be that with no history of vaginal yeast in this mother that it
ISN'T yeast-related.  I just find that  when the symptoms fit, it's the easiest
thing to treat for and rule out before referring on.

Becky Krumwiede, RN, IBCLC
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