Dear Lactnetters,
  You were such a great help with my last question (Immunizations for
mother) that I am asking again for your assistance and opinions.
Baby  was first seen at 4 days. Mother had sore nipples and baby was a
really heavy chewer.Mother was taught to finger feed and do non biting
mouth exercises and was able to put baby more comfortably to breast in
about 1 week. Our next contact with the mother was for a mastitis at 1
month which resolved without antibiotics.
about 2 weeks later the mom called with again very sore nipples.  The baby
presented with thrush, mothers nipples very red. Treated with Baking soda
and water and babys mouth cleared in 10 days, mother still sore.  Put on
Monistat derm, no changes.
Today this is what I saw.
The nipples are very red and the skin at the tip looks almost callased.
Thick and rough. As you look at the breast there is a difference in the
coloration of the areola. The area the babys mouth covers is at least 2
shades lighter than the rest of the areola.The baby is not latching on deep
enough and he has a high palate, but there is no compression of the nipple
seen.  The tips of both nipples blanch both after breastfeeding and after
pumping.Between feedings she has a letdown and  the breasts feel hard.Sharp
tingles are felt in the breast after both breastfeeding and pumping and
when this letdown occurs.  She describes the tingles as being like your
foot fell asleep and you stood on it.  That type and level of pain.
This mother successfully breastfed twins for over a year.  This baby has
nearly doubled birth weight at 2 months 7.8 to 14.00.
Am I still looking at candida? Would Diflucan be the right way to go?
Is this something a dermatologist whould be looking at?
Am I way off and its something else entirely.
Looking foreward to your comments and so is the mother.
TIA
Kathy in So Calif