I have permission to post. Please send any comments on or off-list. This patient will be 
treated with Jack Newman's fluconazole protocol this week x14 days. Any input or ideas 
are welcomed.

The mother writes:

“After breastfeeding my daughter for a couple of months, I developed intermittent 
internal right nipple itching. This intense right nipple itching happens a dozen or so times 
a day and is quite noticeable and bothersome.  There's no rash and the skin is intact.  I 
called my OB's office and was told it could NOT be related to breastfeeding.  (This was 
before I started working in OB myself and knew otherwise).  The itching continued after I 
weaned my baby.  I went to my PCP and she ordered a mammo which was normal and  
soothing/itching creams.  But the internal nipple  itching persisted.  No creams helped.  I 
just learned to live with the intermittent itching for 4 years! 
?
I do not have a good immune system as evidenced by recent labs and history and I am 
currently being evaluated by [infectious disease specialists] and [asthma & allergy 
specialists] for very frequent lung, sinus, urinary, skin, vaginal (fungal) infections.   
Because of these frequent infections,  I must take antibiotics very frequently.  I am also 
on an antihistamine daily for allergies.  Ugh! My charge nurse, and I think this sounds like 
my right breast itching and subsequent pain may  be caused by a breast yeast infection.
?
I had both a very bad skin and vaginal fungal infection last month.  At the same time, my 
right breast also became very tender and it hurt and felt swollen into my axilla, down my 
arm, and to the side of my right breast.  My [OB physician] did a breast exam (lumpy 
bumpy) and imaging studies were all negative.  But he gave my 7 days of diflucan for my 
terrible vaginal yeast infection and he sent me to [infectious disease specialists].
?
My right breast lumpiness, pain, swelling, itching all went away for a couple of 
weeks....but now it is coming back.    First the intermittent itching started.  Now the 
breast is getting tender and I feel tightnesss under my arm.  I am wondering if I need a 
longer treatment to get rid of it?  I see my [infectious disease specialist] again next week 
and I will ask her about a prescription.
?
What do you think?  Have you any experience, or know of any reports, regarding women 
who have persistent unilateral breast itching starting while nursing and persisting after 
weaning?   I know you LCs see this stuff all the time in lactating women.  What would you 
recommend I do?”

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