<I am trying to help a mom who at 4 wks postpartum developed breast and
nipple pain. She is pumping for a small premie baby who has never bf yet. No
visible signs of yeast anywhere in mom or baby, but mom had just finished
antibiotics for endometritis. >
Laurie, I don't think a fungal infection will cause a fever. And i think
mastitis is unlikely if there is no redness / tenderness / lump. Nipple and
breast pain after antibiotics make me think of thrush (yeast). Perhaps the
intermittent fever is related to something else (?unresolved endometitris,
urinary tract infection, etc).

Another case:
>Everything has been going very well with the BF....until the last week.
> She  describes a generalized feeling of "burning, sharp-twinges, pins and
> needles" after BF on one side only.  This has been going on for the last
>week.  She says it happens after every BF, on the left breast only, as "the
breast
>refills."
Barb, I believe you can have thrush with only breast pain and one breast
only. If breastfeeding was going well and now she had pain - something must
have happened. I would try treating her with oral nystatin capsules (2 caps
3 times a day) for a week, before trying fluconazole.
In case I'm giving the impression that all nipple or breast pain is thrush,
I'd better say that I do recognise other causes of pain. But I do see a lot
of women who have had pain for weeks, while the carers have been umming and
ahhing about thrush ("it can't be thrush because the baby hasn't got any
sign of thrush" "it can't be thrush because you've never had it before" "it
can't be thrush because you haven't been on antibiotics" and so on).
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia
PS Some good news - someone was on the radio yesterday talking about
preventing asthma and the FIRST thing he mentioned was breastfeeding.

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