I'm an LC working with an Ob/Gyn MD in a clinic.  We have been working with a mother who has had chronic Rt breast pain.  The mother symptoms started when she was treated with antibiotics for strep throat.  She had a couple of months of pain free nursing prior to the antibiotics.  Her symptoms consisted of a Rt sore nipple and deep, sharp shooting pain of which was worse during and well after feedings were done.  She also c/o  burning sensations and itchiness.  She was treated over a course of 2 months with Nystatin cream for mom's nipples and oral Nystatin for baby.  Mother also had done 2 different courses of Gential Violet for which she stated gave her good relief for a few days but pain always returned.  She then was given a 3+ week course of Diflucan treatment.  She was given a loading dose of 300mg on day 1 and then 150 mg daily.  At the end of mom's 2 week course baby was started on antibiotics for ear infection so mom was left on Diflucan till baby off antibiotics.  Mom's pain has returned and she has been off Diflucan only 4 days.  She is currently using Gentian Violet for a 3 to 4 day course.  Mom's Rt breast has had problems with plugged ducts which she feels has made her symptoms worse and on occassions the Rt nipple gets a blister, cracks  and bleeds .  She is currently on Acidolphilus and Lethicin.  If anyone has any suggestions as to what we should do to treat this mother's chronic breast pain, please e-mail me at: [log in to unmask]   This mother does not want to quit nursing!  Thanks

Jan Miller RN IBCLC

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