Dear Katie

It appears to be quite common that the mother reports excrutiating pain
without white spots being immediately obvious in the babies mouth. In
breastfed babies the plaques sometimes appear in the cheek pouches or high
back in the roof of the mouth where the nipple would "sit". Even in the
absence of this symptom the mother may be aware of the bbay being unsettled,
pulling back,colicky etc.

If the baby is optimally positioned the description of shooting pains is
classic of thrush. In the UK it is possible to purchase topical traetments
over the counter from a pharmacy, however fluconazole can only be purchased as
a 150mg single dose. Dont know situation in US.

Magda Sachs and | have recently compiled a leaflet in th UK because we have
noticed so many cases of thrush which go unrecognised. The words that women
use describe excrutaiting pain and Another supporter recently said having
heard a mother scream in pain she had no doubt that it is a very different
pain from positional.

Please encourage her to ask for treatment or see another HP asap.

Wendy Jones
Breastfeeding Supporter, Breastfeeding Network UK
Pharmacist