Thanks to all for the info on blanched nipples after feeds.  I need to
learn how to differentiate ductal candidiasis from Raynaud's
phenomenon?  This mom has excrutiating pain w/latch-on, once the baby is
latched on deeply there is audible swallowing, yellow smear of stool
with every diaper,  BAD diaper rash, and when the nipple is viewed after
a feeding goes from very pale pale pink to bright white before my eyes.
She has "burning" pain in both breasts, mostly the nipple and areola
"stinging".  No cracks, no erosions, no bleeding.  Baby has been on oral
nystatin and mom on nystatin ointment to breasts for over a week - NO
IMPROVEMENT.  I'm tempted to try diflucan and whatever the archival
search suggests for Raynaud's - but I feel like I should pick one over
the other and go with it.  Besides, I can't very well ask her ob-gyn to
feel comfortable prescribing diflucan and nifedipine for this mom?!  Oh
help, great ones!
ps anyone with info on Thomas Hale's fungal culturing of breastmilk and
how I can contact him?  thanks!!!!!!!!!!!!!!  janna, cpnp, ibclc in w.
htfd. CT

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