My name is Patricia Ellis, RN,MA,IBCLC.  I am a lactation consultant at a large New Jersey hospital with the largest maternity unit in the state. I also operate a private lactation practice, The Mother and Child Reunion. This is my first posting to Lactnet.


In reply to...
Date:    Sun, 16 Jul 2000 20:30:53 -0700
From:    "G. Hertz" <[log in to unmask]>
Subject: Who should prescribe for Mom?

I usually suggest that the mom with possible thrush contact either her pediatrician or obstetrician and tell her that both she and the baby need to be treated.  I have recently had a case where a pediatrician diagnosed thrush in the baby--white patches in the mouth and all--but said nothing to the mother about her need for treatment.  She actually found out through her mother's friends at work!  After contacting me, I advised her to call her obstetrician, who made the recommendation that any med she could give would necessitate weaning, and then commented that since the mom was having such nipple pain, maybe she should stop breastfeeding! (the baby is one month).  We spoke again and she called the OB back, who then reluctantly prescribed an appropriate med.
I think that for myself, I suggest either doctor because I believe that the patient will know which one is most amenable to breastfeeding support, or at least who she thinks is more accessible.  I also tell her that if one doesn't help, try the other one.  I do believe that both specialties should be aware of diagnostic and treatment protocols for thrush.  Regarding mastitis, I always suggest the OB or PCP.  The real problem I have noticed is that regardless of their  title, some doctors just don't believe in the reality of thrush and therefore will not treat.   Unfortunately, the patient is left to persist with her quest and my support until help is found.  It can be frustrating for all concerned, and I am approaching the point of contacting the doctor myself after the mom has called if there seem to be doubts.  Until now, I have not found that to be necessary because I practiced in an area where 99% of the doctors just took care of my referral and I followed up with the patient as needed.
Patricia Ellis, RN, MA, IBCLC
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