First of all, thanks to all of you who responded so quickly to my
questions about Avonex.  I was able to pass on a lot of good data to the
mom, and I believe she'll continue nursing her little girl and take the
medication.

     Today, an OB/Gyn doctor asked me to post another question to all of
the experts out there: He wants to know if there are any scientific studies
proving the existence of ductal yeast and its effective treatment with
medication.  He has a pt (also my client) who is experiencing unilateral
deep breast pain following a course of antibiotics for mastitis.  The
mastitis has cleared, and the MD found no signs of anything wrong in the
breast.  She has a small area of localized pain near the axillary margin of
the breast, and nearly continuous deep aching or burning pain in the
breast, worse after BF.  Her family MD put her on more antibiotics
yesterday and this MD told her to continue taking them "just in case".  I
spoke to him today, gave some anecdotal accounts of breast pain that
resolved after treatment with anti-yeast medication, and wondered aloud if
maybe that could be a part of her problem.  He said he is willing to treat
yeast of the nipple if the baby has obvious thrush or a yeasty diaper rash
(this baby does not), but he is not willing to prescribe antifungal meds on
purely speculative or anecdotal evidence.  He is open to reading studies,
or to hearing from other MD's who could provide evidence that such a
condition exists and is helped by specific meds. Anyone aware of such
studies, please let me know!  I am giving him information on Diflucan from
Dr. Hale's website; does anyone know of additional information about the
advisability of using Diflucan in the breastfeeding mother?  This MD told
me today that Diflucan is far too strong to be used during BF.

     I am at a loss as to what else to suggest to this mom. I wish that she
could at least stop taking the antibiotics if she doesn't need them! She
had yeast of the nipple prior to this, for which she used Lotrimin cream.
Thanks again in advance for your help!  Anne Stiller, RNC, IBCLC