Becki - Welcome to LACTNET.   If damaged nipples don't heal with Tx for
yeast, then it must be something *else*.  I would request a swab of
nipples, or a culture of the milk, and look for a bacterial infection.  If
this was my client in Zimbabwe I would be specifically watching for S
Pyogenes.   If something was found, the lab would send back a list of
antibiotics which would be effective against the offending organism, and a
list to which it is resistant.  I have found that if one of these bacterial
infections *is* found (it always is ...) and mom is treated with the right
antibiotic, that healing finally begins to take place, sometimes after
weeks of deep wounds, pus, and very severe pain.    Good luck.  I'd be
really interested to hear how this turns out.

Pamela Morrison IBCLC, Zimbabwe

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