Candida spores can be washed off intact skin, so if the mother doesn't have cracked nipples from nursing (she is only pumping) it would surprise me if this were yeast. She could have a subclinical or chronic inflammatory mastitis going on, and some signs like the clogged ducts point to this. I have seen mastitis NOT present with fever, and one of the breast surgeons I work with says 25% of the abscesses he sees are not initially accompanied with fever. So I don't think mastitis can be ruled out. However, as this is a woman who is exclusively pumping, it may still be pumping technique. I wonder if her nipples are a good fit with the standard size pump flange. If the nipple diameter is nickel size (an American coin that is about 20mm in diameter) she may swell during pumping and the shaft sides of her nipples may rub abrasively on the flange. Try a larger flange and lower pressure and reassure her that 10 min per pumping session is sufficient. I've seen depressed moms of preemies really injure themselves with aggressive and inappropriate pumping techniques. Barbara Wilson-Clay BSEd, IBCLC Austin Lactation Associates http://www.lactnews.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html