Dear Jane, This poor mom! What I think this family needs to concentrate on right now is doing all these things that they have tried right now while they are on the diflucan, which they probably should continue taking for at least 3 weeks. They need to go on the diet, take acidophilus, clean everything scrupulously. How about gentian violet on the nipples and the baby's mouth, since the nystatin doesn't seem to be working? Or an oral diflucan suspension? Have you tried any of the anti-fungal creams on the nipples instead of nystatin? She could be having an allergic reaction to the nystatin which is adding to the skin irritation. If none of these treatments bring any relief to the nipples, then I would start looking at some other type of infection or a dermatitis. Take another look at Pat Gima's and others' yeast treatment plans. The main point is, the family needs to be treated together, systemically, for at least several weeks with a careful follow-up the next several weeks to prevent a reaccurance. Many of these moms try a lot of things one at a time, but never all at once, which is the only way that it will work if the yeastie beasties have really gotten a foothold. I would keep the formula away from the nipples, for now, it is just another confounding factor. After all this treatment, cultures may or may not show anything. Good luck. This mom sounds like she is at the end of her rope, and for good reason. An all out effort may seem like a lot at this point, but if it gets rid of the yeast for good, then it will be worth it. Sharon Knorr, BSMT, LLLL, IBCLC Lactation Consultant Services Rochester, New York mailto:[log in to unmask] _____________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com Or call Juno at (800) 654-JUNO [654-5866]