I suspect that much of the thrush diagnosed from post feed breast pain
is instead nipple compression, but this case (Carolyn's client with the
7 mo old baby) sounds like ductal thrush. The hot stabbing pain that
seems to travel inward from the nipple to the breast is typical of mom's
reports, and the lack of external signs does not rule it out. If an
oral antifungal agent does not reduce the pain within about 3 days, I
would watch the baby nurse and check for excessive compression or
shallow latch.
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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