Hello all,
I have a client , baby is 10 days old, who has what looks like a contact rash over one section of one areola/breast.  This rash is only on the breast she is directly feeding from.  The other breast she is expressing and has no rash.  She had been applying Daktarin gel liberally to the nipple and areola of both breasts and her baby's mouth for thrush diagnosed whilst still in hosp.
My first question is if the Daktarin was applied to both sides why the rash only one one side? Could it be the combination of the Daktarin and the baby's salivia causing the problem? 
When I first saw her on the 1st she had no symptoms of thrush at this stage so we elected to discontinue the Daktarin for 24 hours.  At this time she also stoppred feeding at the breast and started expressing both sides.  Within 24 hours the rash was no longer as "angry". so the Daktarin has not been recommenced.  She started feeding at the breast on the *rash side*  last night and now on the 4th the rash is still present but visibly reduced.  This mother has a histroy of vaginal thrush and has only just got over a bout, she currently has badly damaged nipples .
The  concern is  that the 4 days of using the Daktarin prior to discontinuing 3 days ago may not long enough to eradicate the thrush completely??
She has used Nilstat vaginally before with good results and intends using it on her nipples and baby's mouth.
She is unable to see her GP.
The 2nd question is should she start using the Nilstat straight away or wait and only use it if her or her baby start showing signs of thrush again? 
thanks Susan 

Susan Day IBCLC
breastfeeding counsellor with Australian Breastfeeding Assn
Mother to 5 daughters aged 13 to 18 months
Kalgoorlie, Western Australia

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