>i have worked with MANY moms in the past year alone who have been on
>diflucan, all sorts of topicals, jointly treating baby and mother, for
>seemingly persistent cases of thrush.  they are at their wits end - with NO
>relief from these approaches when they finally decide to try gentian violet
>(few women seem keen to try it as a first line offense) and their symproms
>COMPLETELY disappear within days.  I am now reticent to rule out thrush
>just because topicals or diflucan doesn't work - although i know that is
>one common wisdom, that if antifungals don't improve the pain, it probably
>isn't fungal. ANyone else have this experience?

Yes, I have this experience often.  I sometimes use GV to affirm my
assumption that we are dealing with yeast.  If mom applies GV and within
hours, as is usually the case, (or certainly a day or two) her nipples are
*much* better, I assume that it is yeast that is resistant to all of the
other treatments that she has used.  I never rule out yeast without a
couple of days of GV. It is still the most effective treatment for the
nipple pain of yeast.  And, I believe that it can go into the ducts and
resolve ductal yeast also.

I recommend its use along with the other treatments, particularly Jack's
APNO. I just wish it weren't so PURPLE.  My clients get used to dealing
with the purple, but it would be so much easier to "sell" if it weren't so
noticeable. At first application, one mother walked out of her bedroom with
a perfectly purple robe. That was a great chuckle.

Pat Gima, IBCLC
Milwaukee, Wisconsin
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