Here's how I now use gentian violet.  First I combine its use with "all
purpose nipple ointment".  The gentian violet is used once a day.  The "all
purpose nipple ointment" (see website below) after all other feeds.  Three
possibilities:

1. The mother's pain disappears after 3 or 4 days.  Great.  Stop gentian
violet, decrease "all purpose nipple ointment" over a week or so.

2. The mother's pain is unchanged after 3 or 4 days, or aaargh! *worse*,
stop gentian violet, continue "all purpose nipple ointment" and call.
Consider possibility that Candida is not the cause.

3. The mother's pain is improved after 3 or 4 days, but not gone.  She
continues both gv and "apno".  The gv for a week *should* be enough and she
should stop it after 7 days.  If pain not gone, continue with "apno" and
then call.

4. If mother's pain is gone, but baby still has thrush, use gv once or twice
more, but if stubbornly refuses to go, stop gv and see what happens.
Usually mother's pain will not return (usually).

Jack Newman, MD, FRCPC