Hi all-
You may remember a week or so ago that I posted my difficult candidiasis
case, with mom having tried nystatin, clotrimazole, and oral diflucon on her
and one of her twins (the other still hospitalized and not of EBM at that
time).  She was still having ductal pain and some nipple pain.  In
desperation, she took him off the breast and put him on ABM while she pumped.
We had cultures done on the milk and on his mouth.  After several days off
the fluconazole, her pain cleared.  Baby is fine.  Cultures grew only a few
contaminants-no yeast.  Everyone is happy, and baby is back at breast at this
time.  She is now pumping milk for the hospitalized twin, and so far, so
good.  Thank you all for your input-esp. the warning that the fluconazole
itself can cause ductal pain!  Altho this experience has been difficult for
mom (an RN and LC herself, newly certified), it has has one good side effect:
 we have done some good education of the OB and ped involved.  We all know
one another well, and they basically reached the point where we showed them
the literature and recommendations, and they prescribed what we asked.  And
we all learned.  This is the way it is 'sposed to be sometimes, I think : )

Thanks for your help!
Denise Mollenkopf, RNC, IBCLC
Florida