Fiona, I'll make the same suggestion here as I did with Jan's recent post (sorry I didn't put that one out to Lactnet, an oversight). Have you explored the possibility of infection, either staph or strep? Unexplained pain, not responding to antifungal tx, might well be infection in the nipple or breast tissue. Can't take credit for this one, was recently put in my place by an OB for suggesting tx for thrush when he determined it was more likely infection. Am waiting to hear the outcome on this as I still think it's less problematic to treat first for thrush and then, if problem persists, treat for infection. Mary A. Banaszewski, RN, Lactation Specialist mailto:[log in to unmask]