Dor mamária na amamentação: os desafios no diagnóstico etiológico

Abstract

Introduction: Breast pain is a hurdle in establishing and maintaining breastfeeding, which often leads to early weaning. Although Candida spp. is commonly considered responsible for painful symptoms, with establishment of treatment, its participation as an etiological agent requires confirmation. Objective: To report cases of persistent breast pain and its association with infectious agents, especially Candida spp. Materials and methods: A study was carried out for one year, at the Human Milk Bank of a Federal University Hospital, to determine the prevalence of breast and nipple candidiasis in lactating women with complaint of persistent breast pain with or without breast lesions. Nipple swabs were collected from eight lactating women and from the oral mucosa of their respective children, and microbiological culture were performed. Results: From the eight swabs collected from the nipples of the lactating women, 5 were negative, 2 were positive for Acinetobacter baumannii and 1 was positive for Serratia marcescens. Candida spp. was not isolated in any microbiological culture from the lactating women or their children. All lactating women and children were treated with antifungal medication and those who had negative culture reported relief in pain. Conclusion: Case reports support the need for further studies to identify the likely etiologic agents responsible for breast pain while breastfeeding. The healthy professionals should pursue the clinical evaluation and proper etiological investigation of breast pain.