A mother of a five month old called yesterday with a problem that has
stumped a number of professionals and I told her I would post her problem to
see if any of you may have some answers for her.  Both she and her baby have
gone through several rounds of antifungal treatment for thrush, including
Diflucan (to which the mother had a reaction), without any relief.  Over the
months, a variety of antifungals, active against a variety of yeasts, have
been prescribed, the latest being Fucidan.  She said she is determined to
keep breastfeeding as her first (not breastfed) is highly allergic, and this
baby (3rd) shows similar tendencies.  When I asked about family Hx of
allergies, eczema, she replied that prior to the reaction to Diflucan (wide
spread rash), she was not sensitive or allergic to anything.  Now she has
some eczema.  She describes both areolae as raw and weeping, somtimes drops,
and that the only medication that seems to help at all is Kenacomb.  After a
few days of treatment the weeping dries up, the skin of the areolae is scaly
and flaky, and the areolae remain deep red in colour.  If she stops the
Kenacomb, the areolae become raw and weeping again within 48 hrs.  Her
pediatrician is in the process of a Medline search as he has never seen
anything like this; her OB/GYN is stumped; and she has seen two other
lactation consultants - no problems with positioning, latch, etc. - baby is
thriving.  Her dermatologist suspects a contact dermatitis and wants to do a
biopsy but the mother has so far refused - that she's in and has experienced
enough pain without going through the biopsy.  Several pharmacists she has
spoken with are also at a loss.  We went over other possibilities re: a
contact dermatitis - change in detergent, areosol deodorant, clothing,
changes in baby's saliva, etc.  Baby is not on any solids, although does
have one bottle/day of ABM (I know - contradiction with allergic
tendencies), mother wears all cotton and when at home/no one around goes
without a bra.  I know this description leaves lots of questions unanswered
- our conversation was shortened by mom's need to attend to the toddler -
but I hope someone has had some similar cases with suggestions to share.  I
won't be able to check Lactnet for the next several days so would appreciate
any postings on this problem copied to my email address as well.  Thanks in
advance for your help.

Shirley Phillips, RN, IBCLC  [log in to unmask]