I've been working with a mother for a week who has continues to have burning
nipples despite correcting positioning and L/O and who now has developed
shooting pains in her breasts.

She had previously treated a vaginal yeast infection working with her midwife,
first with monostat, but she and her midwife felt she developed an allergic
reaction both to nystatin on her nipples and vaginally to the monostat -
increased itching, irritation.  She switched to using gentian violet on both
herself and her baby who had thrush.

She is concerned about taking diflucan [fluconazole] and having a systemic
allergic reaction.  Does anyone know if these prior uses of nystatin and
monostat could cause a cross-reaction?

One complication to her treatment is that this baby's tongue has a wicked
thrust and seems to have frictioned her nipples, and then areola once the
latch was deeper.  Suck training has been resisted by the baby who stops when
the finger is turned over, let alone any pressure being applied to the tongue.
The baby has an indentation in her hard palate which I would not call a bubble
palate as compared to palpating the bubble palate model, but the palate does
curve upward and then come down abruptly and continue as a shelf back to the
soft palate.  She experinces burning of the nipples even with the use of a
nipple shield.  She reports nipple sensitivity in the past when going braless
before pregnancy and breastfeeding.  I have advised her of dietary changes.

Any information, ideas welcomed!!  Thank you,
Mardrey Swenson, DC, IBCLC