<At about 10 days post partum, she started with "shooting pain" starting
in the nipple and extending into the breast.  Antibiotics for sinus
infection just prior to labor and again during labor.  Vaginal yeast
infection during pregnancy.  No symptoms of thrush in baby.  >

Sounds like thrush to me (or yeast to you in the US!).
I have found it difficult to grow candida from the nipple, so don't
recommend trying to culture it. Most of the time the baby will show no sign
of thrush (ie no white spots in mouth or red spots on bottom). But most
people agree it is best to treat baby as well as mother.
(To be pedantic, in medical jargon we say a "symptom" is what the patient
complains of and a "sign" is what the practitioner can see. I've had
problems with editors trying to use these interchangeably, which can be very
irritating!).
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia

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