I doubt seriously that this mother has persistent yeast. She's prob. feeling slightly better on huge loading doses of diflucan because it prob. also has some mild antibiotic activity (much in the same way that some antibiotics may also have some antifungal properties -- mupirocin comes to mind). The history tells the story. Mom's cracks developed in the first weeks postpartum when nosocomial bacterial are most likely to be the causal agents for mastitis. You can have mastitis with no sx of fever. I see this fairly frequently. Sometimes the mom is masking it because she is taking ibuprofen for pain, and sometimes she is the type person who rarely runs a fever when she has other types of infection (sinuses, etc). Lisa Amir's article in JHL talked about using pain rather than febrile sx per se as a better diagnostic indicator of mastitis for this very reason. (Maybe Lisa can chime in here, as she is expert on mastitis and on yeast.) Your case mom was given two antibiotics that would not be many people's first choice when it comes to treating mastitis. She didn't stay on either for the required full 10 days of tx to clear mastitis -- esp. if she picked up a virulent hosptital strain. She prob. has a low-grade mastitis that flares everytime her immune system gets taxed (fatigue, stress, etc). I'm not saying she may not also have some issues with yeast, but if you treat appropriately for something and it doesn't get better, logic forces one to reconsider the diagnosis and try a different approach. Unfortunately, people become so phobic about antibiotics (fearing that it will cause yeast) that they don't treat infections thoroughly, and then they become chronic. I've seen a lot of exhausted, border-line ill moms throw in the towel after weeks and months of extra laundry duty and hocus-pocus when 10 days of an effectively dosed abx would have kept them breastfeeding. Barbara Wilson-Clay BSEd, IBCLC Austin Lactation Associates http://www.lactnews.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html