Dear Ilene,
4 days postpartum is a bit early to see yeast, also it sounds from your case
that this Mom does not experience this pain when she pumps.  If the dx is
yeast then the pump would exhibit the same sx as the breastfeeding.  The
starting on Diflucan and getting better may actually been from not
breastfeeding.
I think you will really need to observe this baby breastfeeding.  An
assessment of the baby's oral anatomy and suck assessment.  The low
production may be due to her discomfort and difficulties to let down.  Has
she tried pain medications, especially ibuprofen?
I don't have an answer and don't feel bad that you are not sure, this is what
keeps our profession interesting.
Ann Perry RN IBCLC
Boston, MA

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