I would question that this is ductal yeast.  Deep breast pain is often associated with a tongue-tie baby who is causing what I call "milk reflux" - the gums or tight oral structures restricting the flow of milk and pushing it back up into the breast.  Changing breasts frequently, using a pump to empty the breast or hand-expression often helps.   I don't use diflucan at all anymore because of this information.  Please refer to Dr. Hale's research on candida for further info.  

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Karen Kurtz
Sent: Friday, August 01, 2014 9:51 PM
Subject: Breast Pain

Cross posting for a desperate mom.  Bear with a somewhat long history to help me try to unravel some answers for a client of mine.  I have a number of different questions with this situation.  Mom called me several days into breastfeeding her third baby.  With her first two she had sore cracked nipples and mastitis in the early weeks but powered through and went on to bf. for 1 ½ years each.  
With this baby same history, by the time she called me she was already taking Cephalexin for mastitis and had deep gorges on both nipples.  Worked on deeper latch, mom had TT clipped a few days ago.  Latch is improving and mom is using APNO on nipples.  Mom also started Diflucan
300 mg. the first day and 150 mg. a day a few days ago.  
Mom is still having a lot of deep breast pain.  With her first two the mastitis resolved quickly.  OB doesn´t want to do a culture but said she has "ductal" yeast and suggested she call me and ask about natural remedies.
So here are the questions:  Is this the correct dose of Diflucan for yeast?  I know that ductal yeast is controversial, but what are other ways to reduce yeast (she is taking probiotics)?  I know that early mastitis is often hospital acquired bacteria, but three times in each postpartum and she never had occurrences again while nursing, any thoughts?  Any other ideas for the pain she is experiencing?Karen Kurtz, IBCLC [log in to unmask]

Professional Lactation Services for
Breastfeeding Success.
http://www.BreastfeedingSuccessNJ.com
(856) 448-4666   (856) 448-4MOM

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