I have a client now who came to see me because of nipple pain.  She is
currently being tx'd for thrush.  Getting little relief from nystatin, so I
suggested duflican.  Of course DR won't write for it and instead gave a
script for mycelex lozenges.  Will this be of any help if the yeast is in
the ducts?  I'm taking the dufilcan info over to the dr's office tomorrow,
don't know if it will change his mind.  However the other problem they are
having is pain and damage from creasing of one nipple.  Baby latches and
appears to be on well. Audible rhythmic swallows.  However nipple on one
side is seriously pinched when baby taken off.  On oral assessment baby's
otherwise rather flat long hard palate ends in a sort of sharp curve.  When
you try to go below it and deeper the baby gags bigtime.  Any suggestions
for creative positioning to alleviate mom's pain and damage.  I'm sure it is
somehow a solvable problem as the other side is not nearly as bad but we
could not achieve it during the consult.  Never felt a palate quite like it.

TIA,

Lori Werrell, IBCLC
Leonardtown MD