This was a rough afternoon. Back to back patients with breastfeeding
problems that have me puzzled.
I saw a 3 month old baby whose mom still has breast pain after yeast
treatment.
About 3 weeks ago the baby had oral thrush and mom had burning breast pain.
After about a week of nystatin treatment neither were better so I gave the
baby Diflucan at 6mg/kg day one then 3mg/kg day 2 to 14.
I gave mom 200mg of Diflucan on day 1 then 150mg day 2 to 14 (they dont
sample the 100mg)
Mom also boiled the pacifier  "5 minutes every day" and boiled the nipples
used for rare feeding of expressed milk.
Mom says her pain improved was almost gone then increased again in the past
few days.
It was burning but now is "shooting, deep in the breast" she denies any
superficial pain, pain radiating from the surface or nipple pain/trauma.
Occasionally between feeds she gets this pain for a second.
Mom denies any engorgement or strenuous upper body activity. ?Lifting her 3
y/o?
Could this still be yeast or would you look to another cause?
Mom is eating yogurt with active cultures and says she doesnt eat a lot of
high sugar foods.
Thanks,
Rob
(who hasnt kept up with Lnet lately)

Rob Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
mailto:[log in to unmask]

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