For the sleepy baby, I would want to know if the baby's mom was GBS positive, and if the baby has been looked at for sepsis. it is unusual for a baby to remain this sleepy and I wonder if the mom is using a lot of narcotic pain relief. As for the mom with persistent painful nipples, I did not get whether or not there were openings in her nipples/slits or cracks? The article that came to mind was Livingstone... JHL. The citation was listed on Kellymom, under sore nipple treatment. Has the mom tried salt water soaks? Just now she's using APNO cream? As for Diflucan, it needs to be used until the mom is pain free for one week acc to Hale, and is Fungistatic, not fungicidal, so the problem is that it is slow working. If the nipple is obviously infected, then talk to your health care provider about the possibility of using an oral (systemic) antibiotic. One study indicated that topical antibiotics and good breastfeeding techniques might not be sufficient if infection is present. (See Livingstone V, Stringer LJ. The treatment of Staphyloccocus aureus infected sore nipples: a randomized comparative study<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10578803&dopt=Abstract>. J Hum Lact. 1999 Sep;15(3):241-6.) See also Oral antibiotic use for sore, cracked nipples <http://www.med.umich.edu/pediatrics/ebm/cats/bfeed.htm>.) -- Best regards, Kathleen B. Bruce RN, BSN, IBCLC [log in to unmask] http://www.etsy.com/shop/HeritageWoolSamplers Independent Registered Board Certified Lactation Consultation Inventor Lactnet & S <http://www.kbbspin.org>pin, Knit, Weave Housecleaning www.kbbspin.org Williston, Vermont *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome