You ask for medical experience. Though I have not been in medical bf for
more than 2 years, here is my .02:
1. I make sure that this is yeast infection. I sometimes feel that yeast
could be overdiagnosed, as the disease of the month ! To make sure, I may
do a mouth swab, though they are less than reliable. As I tell the
mothers:"if we see it, it must be there; but if we don't, we can't say
anything". I may also try a few days of antifungal cream (in fact, I
often do that on the phone, like "until we see each other, try this"): a
local feeling of improvement may be a clue. But I mostly rely on history:
it was going well, than it got worse; history of antibiotic, of vaginal
irritation; pain "typical", etc...  Because, you see, diflucan is not
going to be useful if it ain't yeast...
2. Then, I use Diflucan, 100 mg a day, 200 mg the first day, for a total
of 15 days. I tried 150 mg in one dose, but the lady developed an itch,
and the baby was grumpy for three days. She tolerated 100 mg very
well...  Unless the pain is very localized on the nipple skin, and NO
pain is felt in the breast, I do not mess with creams, except as an
adjunct (to relieve nipples or baby's mouth fast). I never used gentian
violet... sounds too messy for me!

All I know about yeast comes from dr. Jack, by the way.

Now, I have a question: another "grandmother recipe" suggests to use
methylen blue. Have you heard of that one ? Any results ?

Louise Denhez, M.D., M.P.H
Chargee d'enseignement clinique
Departement de medecine sociale et preventive