Pearl, I have seen several mothers have severe allergic reactions to
nystatin.  Both  began use of anti-fungals due to some minor nipple problem
(one has a positioning problem causing pinching, the other had a patch of
what I think was eczema on her areolar edge.)  Both had described their
conditions to someone over the phone and had been told they "for sure had
thrush!"  Based on this, both had called MDs, gotten nystatin prescriptions
and started to self-treat.  In both these cases, they had horrible red
splotching, itching, burning, which of course ph. counselors described as
"thrush getting worse"  so they used more nystatin and ran around the house
boiling everything and getting crankier and crazier by the minute. Nobody
was acting villianously here, just points out the drawbacks of phone
counseling.  Also reminds us that all therapies have risks.  I usually
mention something about possibilities of allergic reactions to threatments
-- even those which are normally benign. The definitive way to handle would
be referral to a dermatologist.  If she won't or can't get into see one (and
around here it sometimes takes weeks to be seen by a skin specialist)  I
would have this mother bathe breast in very mild solution of lukewarm water
with a bit of baking soda in it.  I would have her d/c the nystatin.  She
can use an over-the-counter hydrocortisone cream a time or two for relief of
inflammation (rinsing in cool water before nursing again.) A one-time
bedtime dose of Benadryl elixir (antihistamine) may also help calm things
down.  Once the allergic reaction has been calmed down -- if that's what
this is -- then you can see what you are really dealing with. You can fix
the positioning, whatever.

Don;t forget to ask what else she's been putting on her breasts.  I had a
mom who was lining her bra with tissue -- and turned out to be allergic to
them.  Some moms are putting all sorts of preparations on themselves.  Ivory
Snow is a soap many new moms use for laundry purposes in the US.  Some
people react to that if bras are washed in it.  Does she have a hx of other
atopic dermatitis?  Has anyone else in family got poison ivy or fungal
infection?  Does she have a hyper-reaction to bug bites?  I saw a woman last
week who had a spider bite her at the base of the nipple and what a
reaction!  If you woke up with something like that and didn't know you had
been bitten, what would you think!???  I could kill myself that my camera
was out of film.  What a sight!

Good luck.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html