Hygiene instruction vis a vis hand washing and laundry -- clean towels, changing underwear, etc. are important during active fungal infection. Many of the handouts available (esp. Kay Hoover's nice one with pictures) stress this. I would like to share a strange case, however which points out how yeast-phobia can contribute to a whole family's misery. Asian mom, primip, baby 8 mo old. Baby had thrush at 2 mo pp, successfully treated with nystatin. Mother had tender nipples at the time, and was appropriately advised to treat aggressively with all measure of strenuous hygiene including daily boiling of toys, teats, bras, etc. She continued to have slightly itchy, slightly tender nipples. In spite of lack of sx that fungal infection cont.she was urged by ph. to continue to treat for "thrush". She contacted her brother, a physician, who called in multiple courses of diflucan for her. She cont. the rigorous house cleaning and boiling of clothing, sheets, towels daily. Baby was painted with gentian very frequently, cont. on nystatin. This went on for MONTHS. The feedback she got over the ph. from all manner of counselors was that she hadn't treated vigorously enough or she wouldn't still be tender. She finally saw a smart, breastfeeding friendly MD who told her she didn't see any sign of fungal infection. Mom was dubious, but agreed to come to me. Mother was hostile, and suspicious. When I saw her and took a throrough hx, I told her that I thought she needed to d/c all tx as it had not worked in all this time, and to cont. might be causing or masking the real problem. Her response was "I might get worse." Mine to that: "Good, then we'll have some real sx and can send you to a dermatologist for a real dx." As she was dressing, I noticed her putting tissue in bra over nipples. I asked her if she always did that. She said she always wore a tissue so her "yeasty" nipples wouldn't contaminate her boiled bra. I told her to stop, that cotton was better than paper. She phoned one week later to say all sx were gone. The paper tissues on her nipples had been provoking allergic response. She remembered that during preg. she had worn a brand of paper pads as she was leaking colostrum and that had caused her to break out. I think all the tx she was doing kept her raw and irritated, and the tissues made it worse. So please, lets not put people through the incredible aggrevation of having to live like this by encouraging endless tx for "yeast" in the absence of a real diagnosis. There are real risks from over-medicating and self-treating -- esp. for the baby! And lets remember that allergic dermatitis acts a whole lot like what some people think yeast infections do. Barbara Barbara Wilson-Clay, BS, IBCLC Private Practice, Austin, Texas Owner, Lactnews On-Line Conference Page http://moontower.com/bwc/lactnews.html