I saw a mom 5 weeks ago that I helped with latch.  She also  
complained of a mild burning sensation, so I recommended topical  
lotrimin.  This did nothing and actually got worse.  She went on  
Diflucan 150 mg for 3 days, still no improvement.  Her dermatologist  
now has her on topical neosporin, lotrimin, and hydrocortisone cream.

After reading the article that Cathy Watson Genna posted a few days  
ago (thanks! link below), I suggested that at this point we have  
probably ruled out thrush, and maybe oral antibiotics effective  
against staphylococcus aureus may be the way to go.  I hope that they  
will also be willing to culture her milk, just in case it is  
something else entirely.

Here are links to two articles about oral abx and breastfeeding pain:

http://www.racgp.org.au/document.asp?id=9992

http://www.med.umich.edu/pediatrics/ebm/cats/bfeed.htm

According to this article, the dose is cloxacillin or erythromycin  
500mg qid (four times/day) x 10 days.


I would love to hear from colleagues whether you think I am on the  
right track.  This mom is really suffering, and I really want to help  
her.

Warmly,
Lynnette Hafken, MA, LLLL, IBCLC

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