Fungal vulval infections are normally associated with a vaginal infection which should be treated with an appropriate intravaginal cream or pessary – imidazole drugs to treat vulval/vaginal candidiasis and clindamycin and metronidazole to treat bacterial vaginosis.
Although there is no direct evidence for the vaginal use of these drugs while breastfeeding, their vaginal absorption is minimal, presenting no identifiable risk to the infant. No special precautions are required prior to breastfeeding when used vaginally.