>She tried nursing after the diflucan and the pain still persisted.  she
>reluctantly weaned feeling that there were no more alternatives.
>Well No LAM and she's pregnant again and worried that it will happen
>again.  She's due in April and I have exhausted every avenue availabel
>to figure out what to do as she still says her nipples are sore (even
>not nursing).
Hi Lauren,
I take it that you were pretty sure it was thrush and not something else
like nipple eczema or dermatitis?
If it still seems like thrush, she could take nystatin capsules during the
pregnancy. I prescribe 2 capsules 3 times a day (after food). If she is due
next month, she could continue until she starts breastfeeding (or longer if
she needs to). Is she using anything topically on her nipples now? She can
use GV during pregnancy or another antifungal.
Also look at diet - cutting out sugar, dried fruit, peanuts,etc.
In Australia, fluconazole is even more expensive than what you are quoting
in Canada and the States. And people have to pay for it out of their own
pockets (our health system covers most of the costs of visits to doctors and
hospitals, but not medication).
Lisa Amir
GP / IBCLC in Melbourne, Australia
PS Had my radio and TV debuts last week - still waiting for the call from
Hollywood!