Leslie To recap your case presentation: emergency c/s and abx therapy, then painful nipples x first 2wks - may have been normal but maybe not? Then at 2 wks had mastitis treated w/ homeopathy; possible thrush - patches in baby's mouth; topical treatments have not worked totally; mastitis recurred at 6 wks and was self-treated; nipple tips now pink, irritated, and possible fissure. Baby uses a soother (pacifier). So my differential diagnosis (I'm not really supposed to diagnose becoz I'm not a doctor, but you get the idea) would be 1) thrush which has not been adequately treated in both mother and baby and for long enough time and with effective therapy; nystatin and gv may not work, she has not tried the systemic route yet, may need the long term course of it - refer to archives, Karen Zeretzke's Leaven article on thrush, LC series on candidiasis - and go for the total picture to eliminate thrush like boiling (or discarding) soothers, changing pads, washing bras etc. 2) subclinical mastitis or abscess which may be due to candida or bacterial infection or both - maybe check on ultrasound, probably needs full treatment 3) nipple fissure is infected - candida or bacteria or both, may respond to Dr Jacks all purpose nipple ointment 4) would not recommend weaning from affected side (of course mother can choose to do so) but rather would encourage continued milk expression if too painful to nurse so that lactation on that side can be preserved. Good luck to her and hope this resolves soon. Laurie Wheeler, RN, MN, IBCLC Violet Louisiana, s.e. USA ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html