Anne,

For the OB doctor who wants to see studies documenting yeast in the breast,
and who feels diflucan (fluconazole) is too strong to use during nursing:

Have him order 500 copies of Kay Hoover's 1996, 4 page handout on "The Link
Between Infants' Oral Thrush and Nipple/Breast Pain in Lactating Women."
After he reads about the predisposing factors (such as antibiotic
treatment) and detecting the presence of nipple and breast candidiasis
(including reports of shooting, burning pain that continues after feedings,
and that may occur even with an asymptomatic baby), and a range of possible
treatments (including the dosages for fluconazole), and a list of up to
date references, he will have a wonderful handout with 2 full color pages
of illustrated instructions for the mothers in his practice, all at a
considerable cost savings over purchasing of individual copies.  (And
cheaper than you can copy it yourself, although Kay Hoover gives permission
to do so).

You can get these from Kay Hoover, IBCLC.  The handout has her address and
phone number on it, but I think I can't give it out here, according to
Lactnet rules.  E-mail me privately if you would like it.  We ordered a
large quantity for our state breastfeeding coalition, and have divided them
up so we can supply them to our own area pediatricians, pharmacies, and
directly to mothers.

Anne Altshuler, RN, MS, IBCLC and LLL leader in Madison, WI
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