Several times a week we see women with very sore, burning
>nipples, many times complaining of shooting pains in the breast.  Most of the
>time the babies are asymptomatic.
Ann, I live in Vermont, and at least once a week I see this same thing here.
I think that symptoms may be exacerbated by climate, ie high heat and
humidity, but it is certainly not limited to such climates.

  I havae just listened to the Yeast tape from
>the ILCA conference by Kay Hoover, and gotten some ideas.
I would love to hear this tape myself.  I think that more work needs to be
done in this area...especially since mothers seem to be in exquisite pain if
they call with a yeast like condition. We REALLY want to help them. : )


>Lately more and more women are not responding to Nystatin
his week I had two different women who responded great
>for 2 days, and then all symptoms reappeared.

I find that women react well if the yeast is in the BEGINNING stages.
However, most of the time, I get them when they have been sore for WEEKS,
and thought that bf was supposed to be like that : (  Nystatin is no help at
this point in my experience.  By the time we see mothers, they are usually
beyond the topical yeast phase, into the next phase, which seems to be
characterized by the "liquid fire" feeling, pain that is accentuated when
MER takes place and which lasts well through feeding and after.

 Should we suggest another topical
>treatment if Nystatin doesn't work?  Lotrimin? What about oral medications?
Since I am not a physician, I have worked out a plan to get these mothers
help. I called up a dermatologist in my area. He was a very nice guy, and I
showed him the JHL article that appeared on Sore Nipples, ...it was at least
a year back, but was authored by a dermatologist. The dermatologist I called
has read the article, and has agreed to see these mothers within 24 hours.
He usually recommends either a topical Nizoral cream, or some sort of
mixture of that with topical steroid ointment.  The baby gets treated
orally, and for diaper rash if one exists. However, most of the mothers I
see with suspected yeast end up on oral Diflucan. Ruth Lawrence's book, BF,
A Guide for the Medical Profession deals with this extensively, and I was
sure the dose was in there, but I can't find it now.
 I
>I know about Diflucan, but what dosage is recommended? For how many days?

Kathy A, don't you have this info somewhere from your Florida friend?

Kathleen
>

**********************************************************
Kathleen B. Bruce RN, BSN, IBCLC
Williston, Vermont USA
[log in to unmask]
**********************************************************************