I recently posted a note about a client who had a severe ductal yeast
infection and was Diflucan.  She obtained relief from the shooting breastpain
and sore nipples about 36 hours after taking the one time dose.  On the
advise of her OB she pumped and dumped her milk for the first 24 hours after
taking the medication.  Her baby is 6 weeks old and has been thriving on
exclusive breastfeeding up until this point (despite thrush x 2, and the most
recent ductal yeast).
When she put the baby back to breast, initially she felt she had a surplus of
milk (full breasts, lots of dripping and leaking), but within 48 hours her
milk supply had dropped of significantly.  I got out to see her 2 days later
and by then her breasts were very soft.  Baby latched on well, but I heard
almost NO swallowing, and within 5 mintues of half hearted nursing, the baby
drifted off to sleep, only to awaken as soon as she was taken off the breast.
 It was clear milk supply is down precipitously and the baby is obtaining
very little.  We then tried pumping and again obtained almost no milk (just a
few drops).
I started mom on an SNS and the baby latched on beautifully with an active
suck swallow (gulping) and took in 60cc of milk.  Then she slept.
The mom is now nursing the baby using the SNS at all times except at night.
 Baby is beginning to balk at going on breast without the SNS.  Mom has
continued attempts at electric pumping and hand expression without success.
 (She had had no trouble obtaining 3-4oz of milk q2-3 hours when she pumped
and dumped on the Diflucan.)
Nothing has changed in this mother's history except the Diflucan.  Has anyone
ever heard of an association between this drug and sudden decreased milk
supply?  Does anyone have any other suggestions?  This mother is desperate
and very discouraged.  I had convinced her to continue nursing through the
yeast infection and Diflucan telling her once she got past the infection
things would go more smoothly, but now this!  Any suggestions or comments
would be helpful.
Thanks in advance,
Elaine Webber