Hi Pam. Has her milk been cultured for Staph A? (See Livingstone Article in
currnet Journal Club #2 discussion).

 I find that Nystatin is not very effective if it is thrush, which it may
be..or some sort of fungal infection.  5 days of Diflucan is not enough to
be effective. See Tom Hale's book for recommendations on dosing for
Fluconazole in ductal fungal infections, or do a search for Diflucan where
Hale is the sender, ie

Search Diflucan in Lactnet since Jan 1999 where sender contains cortex

to

[log in to unmask]

This will get you anything Tom has written on this subject in the past year.

Another thing would be to

Search Thrush in Lactnet since Jan 1999 where sender contains newman

Fungal infections are often characterized by a burning pain that is most
severe in between feedings.

Kathleen

Date:    Wed, 15 Mar 2000 13:17:00 -0600
From:    Pamela D Berens <[log in to unmask]>
Subject: Breast Pain

I have a mother who is about 1 month post-partum.  All was well until
about 1 week ago excluding minor L breast pain.  About 1 week ago she
developed excruciating L breast pain primarily begining after nursing
and continuing for some time.  The pain radiates to her back and arm.
This is requiring Vicodin to control. She did have some erythema of the
nipple and the infant had a diaper rash so they have both begun Nystatin
and she has also used oral Diflucan x 5 days due to the severity of her
symptoms.  She states the pain is little improved thus far...What I
think is interesting is that the pain doesn't start until she finishes
nursing - on either breast. Infant is positioned properly and latches
well.  Any ideas? TIA     Pamela Berens

Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html

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