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Subject:
From:
Price Pamela B <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 21 Oct 2003 17:22:26 -0500
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Any advise?
My client has a 3 month old.  Mom had mastitis as diagnosed by her physician
and was on penicillin and then Keflex.  When I saw her as an outpatient two
weeks ago,  she had a yeast infection.  She had symptoms of ductal yeast and
the nipple/areola had signs of a yeast infection.  Her doctors ordered
Diflucan 400mg stat followed by 200mg qday for 14 days. Her baby was started
on Diflucan for thrush as well at the same time.  They are on day 12 of
Diflucan therapy, until less than 5 days ago mom was still on her
antibiotics for the mastitis:
Here is the issue:  her baby still has thrush, mom's symptoms that she
experienced before of ductal yeast, which had almost resolved, are coming
back again, also, mom has a new temp of 103 and she feels very achy, and
nauseated.
Last night mom's toddler came into her bedroom and vomited "all over".

She went to the OB doctor today and he told her the following:
There are different types of yeast infections of the breast, 1. the external
yeast, 2. yeast inside of the breast, and 3. yeast mastitis.
He told her that while she had yeast in the breast before he believes that
now she has yeast mastitis and that is almost impossible to get rid of if
you continue to nurse because the baby keeps thrush and therefore keeps
recontaminating mom but she could pump and feed the baby the breast milk via
bottle.

Mom had called me today before she fed the baby her very first bottle ever,
which by the way mom said did not go very well.  Unfortunatley she got my
voicemail and by the time I returned her call she had already fed the baby.


This is what I think is going on but since this is a new one for me I was
hoping for some input:

I think that mom being on the antibiotic for half of the yeast therapy could
have something to do with her symptoms resurfacing.
Her nausea and fever could be viral, and in conjunction, a resilient yeast
infection.
or the Diflucan may be causing her to have some GI symptoms.
I don't understand why pumping and feeding the milk would help this to
resolve any faster?

Would a Gentian Violet treatment plan work better for this?  Mom really does
not want to continue giving the baby the Diflucan, even for 2 more days, she
feels it hasn't worked yet then it probably won't, I am inclined to agree at
this point.

Mom was originally given the attached Yeast treatment sheet in case anyone
is interested in what information I gave her to start.


 <<Yeast treatment for moms.doc>>
Pam Price IBCLC, CBE
Lactation Services Coordinator
Women's Health
Trident Health System
9330 Medical Plaza Drive
Charleston, S.C. 29406
(843) 824-5013 office
(843) 728-9640 pager

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