Symptoms of nipple yeast infection

What does a nipple yeast infection feel like?

The pain from a nipple yeast infection usually increases with time and can become severe within a few weeks. It generally begins in both breasts at nearly the same time. There is a burning pain in the nipples and areolas during and after breastfeeding, and the area is extremely sensitive and may also be itchy. There is generally equal pain in both breasts. The pain may shoot into the breasts and up to the shoulder blade. Once cracks develop where the nipple and areola meet, a new pain develops. It is severe and sharp and occurs with latching. The previous burning pain during and after feeds continues or increases.

A) Identifying nipple yeast

Nipple yeast infections can be very painful and can recur. Recognizing them early and starting effective treatment will minimize their impact. The timing and type of pain and the changes in the skin of the areola can help with this. 

B) Timing of nipple yeast infections

A nipple yeast infection hardly ever starts during the first few days of breastfeeding. It usually begins after a few weeks or months of pain-free breastfeeding. Nipple pain that starts within the first week of breastfeeding generally has other causes.

Nipple yeast infection pain generally increases with time. It can be severe within a few weeks.

Most nipple pain is settled within two weeks of starting effective treatment.

C) Type of pain

1) Burning pain

Nipple yeast infection begins with a characteristic pain (Francis-Morrill 2004):

  • The pain starts on both breasts at nearly the same time.
  • There is burning pain in the nipples and areolas during breastfeeding.
  • Burning can continue for up to several hours after breastfeeding.
  • There are equal amounts of pain in both breasts unless:
    • There is a crack where the nipple meets the areola (nipple bottom) on one side but not the other, or
    • The mother is only breastfeeding on one breast.

In addition to burning pain, mothers may feel a small amount of itching. They may find that their nipples are extremely sensitive; showers and light touch can be very painful.

2) Shooting or radiating pain away from the nipple

The pain may shoot into the breast. It may also shoot around the outside of the breast and up to the lower part of the shoulder blade during and after breastfeeding (referred pain).

Nipple yeast infections are somewhat unique in their ability to create pain well away from the site of infection. Candida albicans appears to stimulate the nerves that send pain signals to the brain. This stimulates the body’s immune system to fight the infection but may also be the reason for this distant pain (Kashem 2015).

3) Sharp latching pain

Once cracks develop at the nipple bottom, there is a different type of pain. It is severe and sharp and occurs with latching. The previous burning pain during and after feeds will continue or increase.

Cracks caused by a nipple yeast infection can also be complicated by a bacterial infection creating even more pain.

D) Pain that is not likely caused by nipple yeast infection

Nipple yeast infection can be mistaken for another problem.

Nipple yeast infection is unlikely to cause pain on only one side or deep breast pain without nipple pain (Kaski 2018).

References

Francis-Morrill J, Heinig MJ, Pappagianis D, et al. Diagnostic value of signs and symptoms of mammary candidosis among lactating women. J Hum Lact. 2004 Aug;20(3):288-95
 
Kashem SW, Riedl MS, Yao C, et al. Nociceptive Sensory Fibers Drive Interleukin-23 Production from CD301b+ Dermal Dendritic Cells and Drive Protective Cutaneous Immunity. Immunity. 2015 Sep 15;43(3):515-26
 
Kaski K, Kvist LJ. Deep breast pain during lactation: a case-control study in Sweden investigating the role of Candida albicans. Int Breastfeed J. 2018 Jun 7;13:21