Improving breast thrush diagnosis
Breastfeeding is an area of anxiety for new mothers – particularly when there is disagreement between health professionals over the diagnosis and treatment of breastfeeding problems.
Dr Lisa Amir, a general practitioner, lactation consultant and researcher at La Trobe University’s Mother and Child Health Research centre, says that ‘breast thrush’ aff ects up to nine per cent of breastfeeding mothers – but it is often misdiagnosed, leading to the overprescription of antibiotics.
This can set up a vicious cycle in which the burning sensations of nipple and breast thrush persist, sometimes leading to the cessation of breastfeeding. The problem arises, she says, because the yeast organism that causes thrush is not readily detected by a swab of the nipple, whereas bacteria that causes mastitis is, even though it may be present at very low concentrations.
When doctors get results of a nipple swab, they may prescribe antibiotics which do not solve the problem. Some are unaware of breast thrush because there has been little research.
Dr Amir recently received a $751,600 grant from the National Health and Medical Research Council to establish the roles of Candida albicans and Staphylococcus aureus in nipple and breast pain. She will study more than 400 mothers attending the Royal Women’s Hospital and Frances Perry House.
Dr Amir says this is the first longitudinal study of breast thrush and it aims to show how the organism is transmitted and who is at risk of developing the condition. Women who are prone to vaginal thrush may be particularly susceptible. Research has shown that some women’s immune systems are less able to destroy the thrush organism.
‘It is very smart,’ says Dr Amir. ‘It’s a single cell yeast organism that lives in the bowel and vagina. It can change into a more active form called hyphae which burrow into the skin.’
This makes it difficult to pick up in swabs. During birth it can transfer to the baby’s mouth, then to the mother’s breast.
‘We are not in the business of scaring new mothers,’ Dr Amir says. ‘Our aim is to develop a more reliable diagnostic tool for practitioners. Th rush is readily treatable once the condition is diagnosed.’