I have been contacted by another Counsellor with a query and I need further
help.  The Counsellor is seeing a mother with a 7 week old baby with reflux.
The baby does not sleep well--2 hourly at night--and this the second child,
so mother is feeling very tired.  The mother saw a doctor yesterday who
prescribed prepulsid.  The mother noted on the product information that oral
daktarin or miconazole should not be used and she had been using it on her
nipples for thrush.  I said that I would ask:

Why can't oral miconazole be used on her nipples?  (We did discuss putting
it on and then washing off before a feed, but were unsure of this.)  Is
there something else that she can use (e.g. Nystatin)?

The mother is watching her diet for thrush.  She did indulge on Christmas
day which may account for her symptoms now.  She is also trying many othr
things.  She will see her own doctor on Monday, but I said that I would try
to find more information.  She has been trying a number of different
breastfeeding techniques for the reflux--with minor success--and was at the
extremely tired state.  The other Counsellor has talked with her about a
number of *coping strategies* and her husband is on leave so can help with
their first child, giving the mother a chance to rest.

Thank you and I look forward to any replies.
Ruth Berkowitz, NMAA Breastfeeding Counsellor and IBCLC
P.S. I have check the archives and couldn't find anything.