Good evening all,

Question:  Should this mother be treated for vaginal yeast infection?

Two days ago I saw a mother day 3 postpartum with history and symptoms very
suggestive of nipple yeast.  Treated with Gentian Violet and today she is
happy to be symptom-free.  Mother states she had almost unbearable vaginal
itchiness one week before going into labor.  She also recalls nurse doing
vag exam commenting on large amount of "discharge".  Physician took vaginal
swab and culture was negative for yeast. Mother is Group B strep positive
and was given antibiotic during labor.  Mother reports no vaginal symptoms
since birth and now wonders if she should treat for vaginal yeast despite
lack of symptoms.

I would think that she should be treated, especially given how well nipple
symptoms responded to gentian and history.  She could use an OTC preparation
if physician can't be convinced it is necessary.  It seems I remember Jack
mentioning that taking a swab of nipple for yeast culture is quite
useless--but what about vaginal swabs for yeast?  Will lochia help normalize
vaginal flora?

TIA
Genevieve Courant, MSc, RN, IBCLC
Sudbury, Canada