Another issue to be aware of when there is a resistant infection of any
kind is that nipple trauma makes the nipple more vulnerable to
organisms. Check out what the baby is doing with that little tongue and
see if that's contributing to mom's pain and susceptibility to
infection. The moms in my practice who have had recurrent thrush despite
2 week courses of fluconazole have had infants who latch shallowly, use
excessive compression during sucking, and most had subtle tongue-ties
that were not treated.
Treatment induced dermatitis also occurs, and can be hard to tell from
the original infection if the mom is not examined again, but is just
treated over the phone.
Catherine Watson Genna, IBCLC NYC
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