"PTP: Mom with a 5 year old (not nursing) and nursing 16 month old with dx of viral stomatitis. Both kids ran fevers...MD has prescribed antibiotics(?)... 5 yr old and 16 month old both have oral lesions.  Mom now has them on her nipples and is in extreme pain."
 
Stomatitis means "mouth is sore and inflamed." Dr is guessing that it's viral. It may be transmissible, unless it is a contact reaction, which would also explain inflammation of tissues in contact with each other (mouths and nipples).

Antibiotic is likely to prevent secondary bacterial infection, but what about the primary (putative) infection? The concern is that it is herpetic stomatitis, which would be severely painful, but which could be mitigated through prompt use of antiviral medicine, especially if it is the primary outbreak, which tends to be more severe and of longer duration.

Did the Dr culture for herpes? Is there a reason he did not prescribe antivirals, esp in light of the severity of the pain? Does he believe it is caused by a virus which is absolutely resistant to antivirals? 

It is possible he does not understand the severity of the pain. I would advise her to call him right away and exchange more information until they can arrange a plan of care between them that is satisfactory. This conversation should include information on protecting themselves against transmission to the eyes or genitalia, etc. She has the right for her pain to be managed by her health care provider, as it is both a risk to her continued breastfeeding success and a powerful negative effector on her present quality of life.

Arly Helm, MS, IBCLC

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