I posted the info below about a week ago and am hoping for some 
additional responses. Some additional bits of info are included below 
the original post. Thanks,
Jennifer Tow


Original Post:
"I have a client who has thrush --her baby is almost 6 weeks and she 
has obviously had candida for many years. When I first met her, the 
baby was several weeks old and mom had been treated with monistat and 
diflucan once per week (I am serious) with no results. She was 
finger-feeding the baby. When I first saw her, she was seeing a CST, 
which the baby clearly needed (baby was a breech scheduled ceserean). I 
referred for proper treatment with diflucan and APNO. She also was 
using GSE and we made some dietary changes and added some supplements. 
Her milk supply was very low, so we added herbal galactogogues. I 
referred for tongue-tie, which was clipped. I also had mom switch to 
paced bottle-feeding. After the clipping, we waited a couple of days 
and were able to get a very different latch. Even so, mom was not fully 
healed and baby had developed a habit of using the roof of her mouth 
instead of her tomgue to draw in the nipple. I had mom switch the 
bottle and have considered using a pacifier for tug-of-war, but it is 
difficult to fully evaluate improvement as mom still has nipple pain, 
 
Here are my questions. The nipples are MUCH better, but there are now 
blisters and one seems to be developing a bleb. I have her wearing 
breast shells to minimize contact with nipples. I suspect there is a 
secondary bacterial infection, but have obviously been very concerned 
about the prospect of ABX. Has anyone dealt with these blisters in any 
other way? Also, would anyone have a specific bottle or pacifier they 
would use to support proper oral function, as this baby is only going 
to breast a couple of times per day. Latch really is much better, but 
mom resists rapidly pulling baby on due to pain and especially past 
trauma. This really would just be tweeking at the breast if the pain 
were not an issue, but we need to stay mostly off the breast a while 
longer. Also, I have referred to a homeopath for constitutional 
treatment. "

ADDITIONAL INFO:
I am pretty much convinced that the blisters are resulting from the use 
of a smaller than avg siz flange for her pump. She ordered this before 
I ever saw her and I have had her switch to the normal size. Mom also 
said that her nipples have felt erect to her for the past two 
weeks--all of the time. (BTW, she has no nipple blanching or other 
iindication of vasospasm). She also said that she beleives she may have 
had a bleb during her pregnancy and that her nipples were extremely 
itchy while pregnant.  She is amost finished with diflucan and the pain 
on her nipples has not resolved. She tried an Avent hand pump so that 
she can take it with her for appts and found it to be excruciating. 
Should she try an ABX? She is seeing the homeopathin 2 days and I am 
seeing her tomorrow and we are going to discuss the use of myrrh or 
calendula.

Thanks so much. 
Jennifer Tow, IBCLC, CT, USA 

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