I just wanted to ask about a problem I have not been able to resolve.
This mother has had severe breast pain for a month now.  Quite typical
of yeast, but not responding to anything, including fair sized doses of
fluconazole (300 mg/day for almost three weeks now). She feels a little
better perhaps with the fluconazole.  Breastfeeding was never easy, and
she had sore nipples all along.

She feels better when she pumps (also typical of yeast in my
experience), can nurse the baby occasionally, but more than once, and
the pain returns.  Pain is *not* absent when she pumps, but is
tolerable.

Any ideas?

Jack Newman, MD, FRCPC