I saw an interesting case.  A mom nursing baby # 3, now 4 months postpartum.
Pedi dx nipple candida, and while mother had been treating (if a bit
sporadically) with gentian, and nystatin, the condition was not clearing.
This same scenario had occurred with baby #1 and #2 at about the same point
postpartum, and both had been weaned early due to mom's discomfort.

  Mom and Dad and baby came to see me.  What I observed on the nipples did
look fungal, but since treatment had been unsuccessful I began to
investigate other possibilities like dermatitis, etc.  I asked my favorite
question:  Do you have any other areas of broken or irritated skin on your
body.  Mom answered "no", but as I glanced over, there was Dad scratching at
his hands.  Both hands revealed patches of eroded skin between each finger.
Some areas were merely scaley, some were quite irritated.  He told me this
was a chronic condition which he had "always" had but had never discussed
with a doctor.  Baby was on Dad's lap sucking on the car keys which Dad had
been handling.  I suggested they all three be evaluated by a physician.  I
surmised that as the parents became sexually active some months after the
birth of each child, the fungal infection spread to mom's nipples (as I
think the skin integrity is not always great during nursing.)  They agreed
that the time frames were right on this scenario.

 Mom called me yesterday and said pedi had agreed to look at all of them and
agreed Dad's hands do have chronic fungal infection.  He is putting them all
on diflucan.  I think it is really critical to remember that infections
generally clear when treated appropriately.  These chronic cases may involve
several issues: 1. Failure to treat long enough or with approp. meds. 2.
Failure to deal with secondary infections or contact dermatitis which
results from the treatment  #3 Reinfection from another area of the body, or
from another source (family member or animal -- Dogs can have yeast
infections of the ear.  I know because my dog has one now.)

I think this case illustrates one useful role of the LC.  The LC is more
likely to see the mother-baby as a dyad, and to see them within the context
of the family.  Therefore it is easier to catch these cross-infection
situations -- or at least inquire about them.  Consequently, moms with
candida should be asked about other family members with athletes foot, jock
rashes, fingernail candida, ringworm, etc.  All these topical funguses can
be persistant and take weeks of treatment to resolve.

Barbara