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 
finder-feeding the bbay. 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 add some supplementsHer 
milk supply was very low, so we added herbal galactogogues. I referred 
for tongue-tie, which was clipped. I also had mom switch to a 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 yug-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.

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

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