I have a mom that was breastfeeding without difficulties until infant was
13 days old
when she began to have unbearable pain with latch  on and throughout
feed.
Described as pinching pain in the breast during feedings, burning pain
after
feeds.  This is the point that I received the referral from pedi.  I
could see no latch problems, no evidence of thrush in mom or infant.  Mom
had supplemented w/
abm for 31 hours prior to my visit.  It took 48 hours for me to get
fluconazole order for
mom as md felt it was a latch problem.  Mother breastfed and supplemented
during this time.  Started med late 11/19 and when I talked to her 11/20
she was feeling a little better but felt supply was down.  Told her to
continue to breastfeed and start a pump routine ( at least 4 times daily)
, suggested using blessed thistle and
fenugreek.  Had phone call today, mom says she has no milk using abm
again, infant
breastfeeding 20m each side every 1 to 2 hrs.  Has not been able to get
blessed thistle or fenugreek yet.  Has appt with pedi today for infant.
I can not find anything to
link loss of supply with fluconazole, and am at a complete loss as how to
help this
mom.  Incidently pedi not treating infant states gets enough for mom.
Faxed him Hales and K. Hoovers info.
Mom also reports very little pain with breastfeeding now.
I need help fast.  Thanks.
Louise Ferner RNC IBCLC