>culturing milk for yeast and/or using swabs on >the nipple/areolar surface. What are the protocals for this? There aren't any definite protocols for this. I can tell you what I did in the study I did a couple of years ago. "Microbiological samples were taken prior to breast-feeding, in order to avoid contamination of the nipple by the baby's mouth. After cleaning with a sterile water wipe, a cotton-tipped swab moistened with sterile normal saline was rolled over the nipple and areola. The swab was then rolled directly onto one third sector of a horse blood agar (HBA) plate and a Sabouraud agar plate. Then 5-10 ml of breastmilk was hand-expressed into a sterile container, and immediately transported to the laboratory where it was cultured directly onto HBA and Sabouraud agar. A cotton-tipped swab rubbed around the baby's oral mucosa, in particular the tongue area, and then plated onto a third sector of a Sabouraud agar." This has been published in Gynecologic and Obstetric Investigation 1996;41:30-34, Candida albicans: is it associated with nipple pain in lactating women? Amir LH et al. I did find more candida in the women with nipple pain, but most of the time candida did not grow. I think a more sensitive method of detected candida is needed. Clinically I don't take swabs; I tell people it is a clinical diagnosis. Lisa Amir GP / LC in Melbourne, Australia