Dear Janet,

You described:
"I posted a couple of days ago about blanching and throbbing of nipples
post
feed. Have not received any comments to this point. Baby is 3 months old
and
breasfeeding has been going well. Also has deep "syringe like" pain
sensation in
lateral aspects of both breasts unrelated to feedings. No signs of thrush
in
baby. Latch perfect. Nipples are perhaps a brighter pink. I am thinking
thrush and would like feedback on the association of blanching of the
nipple
and thrush. Also what suggestions in addition to dry heat are helpful for
blanching."

In my experience I have found that the thrush you are suspecting is also entrenched in the milk ducts.  The pain that you described is usually
labeled neuralgia ("syringe like" pain).  Some moms also describe the
pain as "aching" or "shooting".

I take a culture of the nipple, breast milk and babe's mouth/buttocks.
Positive results requires Nystatin Suspension for babe; the ointment to
babe's buttocks; ointment to the mom's nipples - treatment to last 14
days; one-dose oral antifungal (to treat systemically the ductal yeast);
warm-moist packs before & after feedings; Advil (for pain relief and
antinflammatory properties); lactobacillus (either tablet form or live
culture in yoghurt) 3-4X day X 14 days,  and of course last but not
least lots of hand washing of mom and dad, clean bras/nightshirts daily,
change breast pads frequently, boil binkies daily, etc.

See ya,

Trina Ammar, RNC, IBCLC
Monterey, CA