On 2/28 I posted about a g2p2 who presented for the first time via phone 9
days post-partum.  Briefly, the scenario was:
   pp1= small crack on one nipple
   pp2= began expressing milk, pp3= vaginal itch and severe dryness of her
mouth
   pp4= saw her ob who prescribed diflucan, pumped and fed baby expressed milk

   pp6= took diflucan once, did a "pump and dump" until PP8
   pp8 = put baby back to the breast
   pp9=nipple pain had increased, no vaginal itching, crack on nipple healed,
baby had small white patches inside mouth. Mom's "seared" feeling inside of
mouth persisted, has tight, dry-skin-like sensation which has traveled from
PP3-9 from one ear, across chin, to other ear, externally.
        My thoughts:  yeast?  Shouldn't mom and baby both have been treated?
Are
they passing it back and forth?  Why didn't she start diflucan as soon as it
was prescribed?  WHY didn't she call sooner?.....

        Here's a followup:  Its now pp13.  For the mom, the MD advised peroxide
gargles, said external and internal facial "thing"  was due to vitamin
deficiency,  did some bloodwork (exactly what, the mom didn't know).  Baby
still has white patches inside mouth and will finally be seen by pediatrician
on March 3.  Infant breastfeeds with no apparent discomfort to mom's nipples,
and MD (who breastfed her own twins) advised applying vaseline to nipples
after each feed.  We discussed vaseline as being occlusive, and concern about
possibility of thrush, and culturing. The MD, who saw only the mom, not the
baby, feels it isn't thrush, so mom is "not concerned". Oh, my.....The saga
continues....
        Sincere thanks to all of you who e-mailed me with your wonderful thoughts and
ideas.  As a special note to Donna Z. (who was disappointed that I, and
others, asked to be e-mailed separately)....I understand your concerns.  I
also wish the case histories would unfold on Lactnet so we could all learn
from them.  Speaking only for myself, I was eager to get some feedback asap,
and knew I might not have the opportunity to read my digests for a few days.
But I agree, its frustrating not to be able to see the outcomes of some cases!

Joyce Blangiardo RN, FACCE, IBCLC
([log in to unmask]) here on Long Island, NY who hopes you all don't have
eyestrain from reading my lengthy letter to Oprah, & knows IBCLC's and LLLL
are special treasures.
Roses of appreciation to all of you:   @--->--->------