Has this mom used gentian violet?  I find it more effective than diflucan 
for nipples, and often the deep breast pain resolves after topical 
treatment...appears to be referred pain from the nipple.  I very rarely use 
diflucan at all anymore...if deep stabbing pain persists after gentian 
violet there is usually vasospasm.  If gentian violet (1/2% applied to 
nipples daily for 5-7 days and babies' mouths for 2-3 days since they are so 
young and have no visible thrush)doesn't do the trick for this mom, I would 
have her try a heating pad immediately after nursing and see if this helps 
her pain.

Kathy Leeper, MD, IBCLC
Lincoln,  NE 

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