Jan:  It sounds like deep ductal yeast...tough to treat too.  Do you have
my article?  Okay...here are a few random thoughts assuming you've seen my
Midwifery Today article (I can email it if you want it)...

-have her stop wearing a bra and use 2c distilled white vinegar in the
rinse cycle of ALL her laundry.
-make sure she does not sleep on her stomach (ideally not on slides either)
-deep breast massage while nursing using a lubricant such as olive or almond oil
-deep breast massage while in bath tub (with several cups distilled white
vinegar in the tub)  suspending breasts to get full drainage and watch as
milk disperses into water (you can actually see strings of yeast this way)
-continuously take an anti-inflamatory such as ibuprophen
-continue lecithin gel caps 3 TID
-start as systemic program to deal with yeast and build up intestinal flora
with Lactobacilli and FOS, while reducing sugar, fermented products, and
yeast products.
-gentian violet her nipples, areola, and breast (yes--big time mess) for
three days (still need systemic though) OR get Mycelex trouches, crush,
dissolve and apply.

It is entirely possible that she is actually allergic to yeast or that her
baby is and this is causing the continued problem (I had this with my
second son--after he weaned at 3 yrs, never had a problem;  turns out he is
allergic to yeast and was triggering an inflamatory reaction in my breast).
Even with systemic treatment, she will have to do the above protocol (plus
what's in the article).   Has she been on a full course of Tx of Diflucan
(400 mg loading dose with 3+ weeks of 200 mg/day), plus topicals such as
Nizoral or Sporanex?  If this didn't work or doc is not willing to Rx, ask
for systemic Nizoral (2-3 weeks worth) with topical.  If this isn't
acceptable, then try a very long course of oral Nystatin (6+ weeks), but
48% of yeast strains are resistant to Nystatin.


: )Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC  email: [log in to unmask]  : )
: )HSR & Health Educational Consultant        voice/fax: 541 753 7340   : )
: )------------**CHANGE THE WORLD, NURTURE A CHILD!**------------------ : )