DIAGNOSIS AND TREATMENT OF THRUSH DURING BREASTFEEDING: ADVICE AND EXPERIENCE IN PRACTICES

Background: An early and correct detection of Oropharyngeal candidiasis (OPC) in breastfed infants or Candidiasis of the breast and/or nipple followed by effective treatment are crucial to avoid pain during breastfeeding, possible followed by premature weaning. Objectives: We aim to assess the experience of mothers with symptoms of thrush during breastfeeding and to research the current treatment of OPC or candidiasis during breastfeeding prescribed by health care providers (HCP). Methods: A cross-sectional observational study was conducted in Belgium in both HCP and breastfeeding mothers. An online questionnaire was available in different languages for both mothers and HCPs. The answers were coded in Excel and descriptive statistics were applied to calculate numbers. Results: Most mothers felt a stabbing or burning pain that was tolerable. The majority of mother consulted their General Practitioner (80%), followed by paediatricians and midwives. Mothers were not always satisfied and find the received advice incomplete. For the baby, miconazole and nystatin were prescribed most often, while for the mother, miconazole and fluconazole was advised. About 50% of the mother used no drug treatment. 48% of mothers used alternative therapy. Most midwives believe there are no clear guidelines for the diagnosis and treatment of thrush during breastfeeding. Most pharmacists believe there are sufficient guidelines. Conclusions: Miconazole and nystatin are the primary choices in the treatment of OPC. Miconazole and fluconazole were used for the mother. Research on the effectiveness and safety of treatment is needed. HCPs need correct knowledge of diagnosis and treatment of thrush in breastfeeding.