Several times a week we see women with very sore, burning >nipples, many times complaining of shooting pains in the breast. Most of the >time the babies are asymptomatic. Ann, I live in Vermont, and at least once a week I see this same thing here. I think that symptoms may be exacerbated by climate, ie high heat and humidity, but it is certainly not limited to such climates. I havae just listened to the Yeast tape from >the ILCA conference by Kay Hoover, and gotten some ideas. I would love to hear this tape myself. I think that more work needs to be done in this area...especially since mothers seem to be in exquisite pain if they call with a yeast like condition. We REALLY want to help them. : ) >Lately more and more women are not responding to Nystatin his week I had two different women who responded great >for 2 days, and then all symptoms reappeared. I find that women react well if the yeast is in the BEGINNING stages. However, most of the time, I get them when they have been sore for WEEKS, and thought that bf was supposed to be like that : ( Nystatin is no help at this point in my experience. By the time we see mothers, they are usually beyond the topical yeast phase, into the next phase, which seems to be characterized by the "liquid fire" feeling, pain that is accentuated when MER takes place and which lasts well through feeding and after. Should we suggest another topical >treatment if Nystatin doesn't work? Lotrimin? What about oral medications? Since I am not a physician, I have worked out a plan to get these mothers help. I called up a dermatologist in my area. He was a very nice guy, and I showed him the JHL article that appeared on Sore Nipples, ...it was at least a year back, but was authored by a dermatologist. The dermatologist I called has read the article, and has agreed to see these mothers within 24 hours. He usually recommends either a topical Nizoral cream, or some sort of mixture of that with topical steroid ointment. The baby gets treated orally, and for diaper rash if one exists. However, most of the mothers I see with suspected yeast end up on oral Diflucan. Ruth Lawrence's book, BF, A Guide for the Medical Profession deals with this extensively, and I was sure the dose was in there, but I can't find it now. I >I know about Diflucan, but what dosage is recommended? For how many days? Kathy A, don't you have this info somewhere from your Florida friend? Kathleen > ********************************************************** Kathleen B. Bruce RN, BSN, IBCLC Williston, Vermont USA [log in to unmask] **********************************************************************