The research you cite on treating both of the dyad when one has symptoms of 
thrush might not be considered reason enough to say conclusively that both 
SHOULD ALWAYS BE TREATED. I have seen many cases successfully resolve when 
only one of the dyad was treated (whether it be mother or baby). I think a 
professional discussion and agree to disagree is indicated here between the 
LC and the pediatrician.

I can see the peds point of not wanting to give medication to an infant when 
it may not really be necessary. It is good that a doctor is reluctant to 
prescribe without there being a really good reason. It may be that in the 
LC's experience she has seen many cases of thrush NOT RESOLVE unless both of 
the dyad were treated and she could certainly share her experiences with the 
doctor.

On a personal note, I had a bad case of oral thrush/vaginal yeast after 
being hospitalized and on several antibiotics. The nystatin did virtually 
nothing but the diflucan pills (I took one each day for 4 days) worked 
great!

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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