>>Although nystatin is not well absorbed from the digestive tract, I have
found many women find a reduction in shooting/ burning/aching breast pain
that we associate with thrush in the breast. I have treated literally
hundreds of women in the last 6 years with thrush, and most respond to
nystatin ii tds, in addition to topical antifungal treatment for the nipples
and for the baby's mouth.<<

Lisa,
I am wondering about the regional issues here.  Several years ago, nystatin
was the common treatment for nipple thrush and worked well. Ductal yeast was
almost unheard of! In the past few years, however, it has become much less
effective; some of us wonder if yeast now comes in "tougher" strains! Could
the situation be different in Australia than the U.S.? An outside thought, I
know, but how else to you account for different treatment results? Unless the
problem is that we wait too long in dx and tx....   It has been my experience
(as well as that of other LC's I know) that oral nystatin for mom does little
or no good, and that diflucan has the best shot in eliminating the problem.
Yes, it is definitely a more expensive option, but not as expensive as I've
heard quoted for outside the U.S.  What I see here is that everything else
will be tried on a mom first, and when she doesn't respond, the case becomes
so entrenched that it is difficult to get rid of, period, and mom loses the
energy to fight. I'm tired of seeing moms quit because of all they have been
put through.......

-Lisa Marasco, LLLL, IBCLC
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