>Seems no matter what we
>do, mom has nipple/shooting breast pain unless she's on Diflucan.

Hi Becky (nice to be able to put a face to the name!)
rather than longterm fluconazole, I would give a trial of nystatin (2 caps
tds). Obviously this is not as effective as fluconazole, but I have
certainly found it can keep the thrush at bay. The benefits are that it is
cheap (we can write an "authority" script that lasts 6 months) and very
safe.
Another thought could be one dose of fluconazole /week -as is used in AIDS
patients or women with persistent vaginal thrush. You could gradually wean
her from a daily dose to a weekly dose.
Good luck,
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia

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