< In the meantime, I had given
her Dr. Jack's handout on gentian violet and suggested she try it because
I
still thought yeast. Yesterday, the baby developed thrush in her mouth
(suprise) so she tried the GV. Well, the baby screamed and gagged and
vomited. This mother is so upset because she thinks she did a terrible
thing
to her baby. I know the pediatrician will be furious with me when she
sees
the purple mouth. The only GV she could get is in an alcohol base but she
only swabbed the mouth. She also covered her nipples and says she is
getting
some relief.>

Today while someone else on our staff was assessing a client I looked up
GV in '99-2000 edition of MMM and began calling local chain pharmacies to
find one who stocked it. All of them who had it in stock mentioned having
1% solution  with a 9-10% alcohol base. I found one pharmacist willing to
compound it as described in MMM, (without alcohol), but not without a
written Rx from a local physician.

I found MMM confusing in regard to the phrase "aqueous (non-alcohol)",
and the reference is a personal communication from Dr. Newman.  I called
Dr. Hale directly for advice. ('bout dropped my uppers when he answered
personally!)

Dr. Hale, will you please post to the list  what you told me to have the
mother do to obtain 0.5% strength and what strength and effect the
alcohol would than have or not have? You also mention a range of  0.25%
to 0.5%. Please comment on that too. Also, someone told me it is possible
to have the pharmacist flavor it (for instance, with grape). What do you
have to say about that, since it seems to taste so bad?

The pharmacists I then called were very agreeable to providing the mother
with an extra empty bottle so she could proceed to follow your directions
from there (with the least mess) .

Kim, as a CYA maneuver (U.S. slang for trying to avoid any problems of
seeming to overstep my bounds), I sent along a copy of the GV page with a
notation concerning my conversation with Dr. Hale.

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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