Hi. Just talked with a mom today with a 6 month old baby. Breastfeeding has
gone well except for reccuring sore nipples over the past few months or
more. She usually gets a red rash around the areola and a whitish ring
around the nipple. She also has burning, itching and throbing in the
breast. Pain is during a feeding and sometimes between feedings.
She has been treated for thrush several times. Tried nystatin, gentian
violet, and diflucan. Diflucan was for 6 weeks (similar dosage found in
Hale). Diflucan really helped but now problem is back. Baby was thought to
have thrush also-plus a yeast diaper rash. Baby has not been treated orally
with anything since Dr. felt baby would get diflucan through breast milk.

I understand that Diflucan has a higher relative infant dose, but should
baby also be put on Diflucan? Mom has had chronic athlete's foot for at
least 10 years.  She also has Raynaud's which is most noticeable in her
toes. She also said that her let down is still very painful-could this be
related to the Raynaud's?

This is the first time I have talked with her. She has talked with 2 other
LC's and doctors. She is being referred to a disease specialist.  Any
thoughts or ideas? I was wondering if baby needs to be treated orally with
something because baby may be reinfecting mom.  Thanks.

Christine Lichte, LLL Leader, IBCLC

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