I appreciated Fiona's comments.  I have said the same thing about nipple
pain. Because broken skin can easily provide an opportunity for overgrowth
of candida, it makes sense to try to solve nipple pain and non-healing
nipple tissue with antifungal tx. If you treat  thoroughly, and for a
reasonable length of time, with a variety of antifungal agents, and it
DOESN'T RESOLVE, in my opinion, it isn'tcandida.  There are other
possibilities: viral infections, anatomical anomoly, sucking issues, perhaps
atopy. Also, if supply is low or let-down slow, babies suck very hard, using
too much negative pressure trying to extract the milk.  This can cause
breaks in the skin that keep the nipples very sore.  The nipple tissue is so
sensitive that nerve endings, once irritated, radiate deep into the breasts.
Its similar to getting a smashed finger tip or a burn -- your whole hand can
hurt. So the vocabulary mothers use to describe this sensation, ie "burning"
sensations, may also result from a kind of radiating neuralgia from such
inflamed nerve endings.  So I while I have certainly seen cases where tx for
nipple candidiasis resulted in very good outcomes -- indicating to me that
this kind of candidal infection does exist, all cases of unresolved nipple
pain are clearly not yeast.  If the tx doesn't work, I think pursuing other
options or another dx is in order, because some of the oral drugs used to
treat candidat are very powerful.

Just MHO, and a second to Fiona's thoughtful post.
Barbara


Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html