While anything is possible, and while strains of yeast do develop resistance
to antifungals, I think "yeast" has become a catch-all phrase for "mystery
pain/problem."  I saw a mother twice this month for tender nipples.  The
first child she nursed was weaned because she had been convinced by a bfg
counselor that she had resistant yeast.  When the MD wouldn't consent to
diflucan tx when there were no real symptoms, she simply gave up.  This time
round, I noticed a slight diaper rash, and suggested gentian violet,
corrected some positioning problems which were the source of mechanical
problems.  I went back yest. because of complaints one nipple is still
tender after nursing.  We re-practiced latch techniques, talked about
another 3 day use of gentian, etc.  After a lovely feed, mom took warm baby
away from body to lay her down.  We were standing, talking under an air
conditioning vent when she exclaimed:  Now my nipple is beginning to sting.
A quick look revealed a blanched nipple -- a vasospasm!  She told me her
nipples have always been very cold sensitive.  I think that the mild kind of
trauma she had been experiencing from latch, and perhaps a very mild fungal
infection had increased the nipple sensitivity.  Each time baby was on the
breast it got warm, and then abruptly, cold.  What a relief to her to know
that she has an annoying but not dangerous situation.  We put a hot compress
on her breast, and talked about comfort measures.  I reinforced the need to
get the latch right and to finish eradication of any fungal overgrowth.
People get worried with mystery pain and imagine the worst.  Now she will be
able to just get on with it, and said:  It's not really bad pain, it just
concerned me when I couldn't explain it."

So I think that we have to be detectives and not just call everything yeast
like we call all bad crying "colic."

Just my opinion.
Barbara


Barbara Wilson-Clay BSEd., IBCLC
Private Practice, Austin Texas
Visit the "LactNews-On-Line" Web Page
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