Hi All,
I'm working with a mother who has painful nipple cracks at the juncture of 
her left nipple and areola. Infant now 14 days old, latch looks reasonably 
good at this point. Her right nipple had been fine, until a couple of days 
ago, but is now pink and sore. So I suspect yeast - no visible signs of 
thrush in baby, but I still think there is a good possibility this is 
yeast. This mother had a prior reaction to Metrogel, so topical yeast 
preparations are out of the question. I was trying to convince her to use 
a combination of Gentian Violet followed by Diflucan if necessary, but she 
is eager to move right to Diflucan and skip the GV.(She had taken single 
doses of Diflucan in the past with no problems, but who knows what 14 plus 
days of the stuff might do to her) OB willing to use whatever I suggest. 
Pediatrician told her due to Metrogel reaction that she would be unable to 
treat infant. My question is - since mother is reluctant to use GV, though 
it seems logical in this case, what have your collecitve experiences been 
with it. And if we do use it, do you guys dilute it? I know it can cause 
mouth ulcerations, has anyone come across this or other complications with 
it? I don't want to push it too hard, if people have been seeing problems 
with it, on the other hand I don't want to leave the baby untreated. 
Thanks in advance for any suggestions.
Kathy Lilleskov RN IBCLC

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