I've had 2 clients now whose longterm nipple pain cleared w/ a course of
oral nystatin for the mom.  One had been in pain for *9 months*.  Her only
symptoms was pain and slight pinkness;  otherwise mom and baby looked fine.
They tried the usual ointment/liquid route a couple times, dr wouldn't
prescribe diflucan, and I didn't know about gentian violet.  I don't know
how they hit on having mom take nystatin;  it sure wasn't *my* idea.  And
it worked.

The second one had been in discomfort or pain for the first couple months
of her baby's life.  Nystatin ointment/liquid didn't work, nor did gentian
violet.  Baby's tongue was a sort of delicate white - could be thrush,
might not be.  She had the same dr, so no diflucan.  But lo and behold, the
nystatin capsules worked.  And the baby's tongue is pink now.

Nystatin isn't really absorbed from the gut, so this wouldn't be expected
to work.  Could it be that these moms kept reinfecting themselves by
putting hand to mouth, then to breast, and clearing their gut eliminated
the source of reinfection???  (Incidentally, the second mom "had a slight
funny taste" in her mouth that went away w/ the nystatin, as well as a
slight color to the back of her tongue...)

Diane Wiessinger, MS, IBCLC  Ithaca, NY