Barbara,
I think you are on to something. I have often wondered why every LC practice
seemed to have lots of clients with yeast, but I didn't see it much, nor
ever have it to my knowledge, even though I live in the Deep South USA, a
very hot humid place.  I think we have to get over thinking that every case
of nipple/breast pain is yeast (exaggerating a bit here). <<Typically, these
women have had cracked nipples, some early (usually short exposure) to
antibiotic tx for something, and they complain of irritated nipples, breast
pain that stabs and burns, is worsened by hot water, hot weather, and touch
point pressure.>>  Our mindset has been yeast, yeast, yeast for so long.
<< A second opinion from a diff. OB stated that altho the first OB had tx
for mastitis, the mother had been given the wrong antibiotic, for the wrong
lenght of time, in a too-weak dosage strength.  Mother cleared up fine with
better drug tx.  Her sx were chronic pain, reddness on the breast, no
fever.>> Here, we have to get over the fear of giving the mom thrush, or
making the mom worse by giving abx. We do need much more info so we can
differentiate between signs and symptoms of thrush vs bacterial mastitis,
and risk factors for each.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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