HI Rachel,

Here are a few ideas:
raynauds
eczema
bacterial infection
resistant thrush.

I would reculture off topical for 24 hours.  I would culture the milk adding 
ferrous sulfate if you can arrange it with the lab.  I would then add 
bactorban and a topical steroid to her nipple cream.  I would evaluate for raynauds. 
Is she ingesting alot of caffiene?   Good luck 

Christine Betzold NP IBCLC MSN

www.theBFclinic.com

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