I would consider that perhaps this family is not dealing with thrush - especially after all of that flucanazole.  Perhaps the pain is being caused by a poor latch, vasospasms, pumping injury, or bacterial infection.  Treatments such as Gentian Violet, creams, and applications of other substances can sometimes contribute to the discomfort rather than the cure by causing irritation and dryness.  It can be easy for parents to confuse milk on the tongue and structures such as Epstein Pearls for thrush.  My experience is that thrush is pretty unusual in lactation.

Ellen

Ellen J. Rubin, MA, IBCLC, LLLL

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