I am turning to the wise minds of lactnet for help with this situation. Mom came to me at the WIC office with severe pain in her breasts. Described it like shards of glass inside. Baby 4do. Vaginal birth. Mom is a group B strep carrier and was treated with antibiotics prior to birth. Has hx of vaginal yeast infections. So okay I suspect this is thrush. Mom says pain is too great to put baby to breast but is willing to try an electric pump (huh?) to keep her supply up while she deals with the pain. Agrees to pump 8-10 times/day or breastfeed if she can tolerate it. Mom goes to OB gets 5 days of Diflucan. Two days later she is feeling much better. Calls me (on a friday), I set up a plan to get baby back on breast. Suggest she stop pumping and only nurse over the weekend and to come for a wt check on Monday, call me if things aren't going well (ie: mom or baby frustrated, any pain etc). Comes in on Monday and tells me she could only "stand it" until 4pm on Saturday and 2pm on Sunday. Used ABM or expressed milk in bottle in the afternoons and evenings. Has only been expressing < 1oz each time (using double pump lactina). Pain is returning. No sign in baby of thrush (mouth, diaper area, not fussy). Describes pain as similar to first time but not as severe. I suspect not long enough TX with Diflucan, ask her to return to OB for another course. Baby hasn't gained any weight in 1 week (in fact lost 1oz). I'm concerned about her milk supply and origin of pain and baby's lack of wt gain. Mom is visibly distressed. I ask her what SHE wants to do. She decides she will pump as often as she can, not put the baby to breast until she can deal with the pain again. Called this am: has gotten another 5 days of Diflucan from OB plus a once a month pill. Nursed baby at breast last on 4/2. Says she can hear baby swallow at breast. Is pumping only 3-4 times/day, knows this is not optimal but can't deal with pain. Is using fenugreek as well. Only gets <1oz per session (same as when she was pumping 8-10 times) and is discouraged. Breastfeeding remains painful (shooting pains) before, during and after nursing! Any ideas what else could be going on here? P.S. I have never been able to see the baby at breast. Was zonked out the one time I had them both in the office. I can't spend that much time with them when they are there so we couldn't wake the baby up enough to breastfeed in the time that I had with her. She does state though that he accepts the breast willingly and is not usually very sleepy. I'm a little bit embarrassed to post this because I feel I should be able to figure this out but I can't. :-( Thanks, Ilene Fabisch, IBCLC Brockton, MA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html