Thanks, Jan, for the extended explanation.  Your husband's remarks are
exactly the case. Nystatin works for the babies because it is their
digestive system that is involved--- mouth to rectum. The nystatin
doesn't have to be absorbed because these are "external" and get the
treatment directly. The breast, however, isn't connected to the digestive
system, and since nystatin basically is not absorbed orally, it can't
reach the milk ducts. There are really only two choices: nizoral or
diflucan. Of the two, the latter seems the least risky. As previously
mentioned, the original rationale for its use was the fact that it is
used on premature babies in the NICU with life-threatening yeast. The
amount that ends up in the baby via breastmilk is less than the
therapeutic dosage. As with all things, the risks must be weighed against
the benefits, and the mother properly screened by her MD for safe usage
of the drug.  My only guess as to why some mothers clear up when taking
nystatin is that they were going to clear up anyway, as some do
spontaneously. I don't know otherwise.

Regarding herbal remedies: I'm not experienced here, but I've heard about
calendula gel topically for nipples and bottom, and pau d'arco tea for
systemic. Anyone else?

-Lisa

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Lisa A. Marasco, IBCLC                                /  [log in to unmask]
International Board Certified Lactation Consultant    /  [log in to unmask]

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