I would have her paint the nipples/areolae with 1/2% gentian violet QD 
X5...if cured, continue APNO and treat baby for 2-3 days.

If gentian violet does not significantly improve her symptoms in 3 days, it 
is not yeast, and someone needs to observe a feeding when the baby actually 
eats!  ; )  But the description of the pain, out of proportion with physical 
findings suggests yeast to me.  Plus she had overgroeth vaginally right 
before delivery...

Let us know what happens-

Kathy Leeper, MD, IBCLC
Lincoln, NE 

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