Hope I can get a quick answer here.  :-)

I have a mom who I've been working with for about 6 weeks. Baby had a
yeast diaper rash which was treated with nystatin cream and oral, and
mother started monistat when nipple soreness appeared as well. Symptoms
abated in first one, then the other, but were never entirely eradicated.
Now intermittent breast pains have increased, are burning and
discouraging, and I recommended that she pursue diflucan with her OB's
office. The attending NP (who was my bfg instructor way back when) has
already been given Brigg's and Lawrence's info on diflucan, but she has
refused treatment in the past. This time, because my mom is an RN and
they know each other, she reluctantly prescribed diflucan, a one-shot
150mg tablet, only upon the promise that the mother would pump and dump
for one week.  I know that the 7-10 regular courses are being used
successfully for these situations and breastfeeding is being continued,
but I have no info on the one-megadose deal. Can anyone tell me 1) why
this office would use only the megadose treatment for all candida
problems (this was stated to mom), 2) if indeed this megadose is too
great for bfg safely, which I might find understandable, and 3) when bfg
should be safe to resume?  It has been Wed-Mon, and mom says she thinks
she feels better, but isn't sure; still had some stabbing pains while
pumping this am.

This is the same mom I wrote about earlier who had the unusual and poor
functioning nipple, and who is breastfeeding on one breast only. We were
just about ready to graduate her when the yeast cropped back up, and with
all this pumping and dumping (she doesn't pump often enough, her life is
very hectic), she has lost ground on milk supply. I would like to help
her get through this with all possible efficacy. Any hints, info, etc.
would be greatly appreciated.

-Lisa

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Lisa A. Marasco, IBCLC                                /  [log in to unmask]
International Board Certified Lactation Consultant    /  [log in to unmask]

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