> However, for a mom with ductal thrush..... nystatin never
>gets into her system, it just passes through the digestive tract, so it never
>reaches her breast. Not much help!  :-)

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.

We think that nystatin may be effective by reducing the total load of
candida in the woman's body, so that she is better able to fight against the
candida in the breast. Additionally I wonder about the gut-mammary
circulation: could small quanitites of nystatin preferentially reach the
breast? (I have an article somewhere discussing bile salts in a breast
cyst). I remember reading something else about nystatin being found to be
effective for something completely seemingly irrelevant (?a type of
deafness) - so perhaps we don't fully understand this drug.

The major benefit of nystatin is its safety...... No serious side-effects at
all. Also its price is very reasonable.

I'm not totally against fluconazole: but it is expensive.

Lisa Amir
GP / LC in Melbourne, Australia