I just got a call from a mother and wondered if anyone might have some insight as to where to direct this mother if I am not thinking through this well: Very experienced mother - long time breastfeeding 1-2 years with each child or longer 4th baby about 10 months Started in Sept. with crack at base of Left nipple only. Dr. treated for yeast with APNO and after little improvement went to Diflucan When she called me the baby was not being treated - contacted her Pedi and baby was put on Nystatin and both continued to be treated Little improvement after the Diflucan with one treatment - Dr who has also nursed her children still thinks it is yeast. Mom now on Diflucan for 5th week - Baby now on Diflucan. Mother describes the nipple only areas as "burning fire" pain during and immediately after nursing Now both the left and right nipples both broken skin - Dr. tried Bactroban only (mother reported this burned her nipples a lot - did not see much change. Dr. put mother on another ointment called Biafine but not much change noted. This mother called me today and is absolutely at the "end" she is literally crying if she nurses her baby and is even awakened at night with the pain in both nipples only. Mother describes the nipple areas as cracks in the skin ( like tears at the base of each nipple). Skin seems to be peeling off. Mother has cut out sweets and lowered her carbs Pumping is a little less painful, but this baby has never had a bottle or pacifier since birth and refuses a bottle. I suggested using a sippy cup with breastmilk - Mother is planning to see a dermatologist today and will ask that a culture be done. I keep wondering if this is a Staph infection??? MRSA??? Any suggestions would be appreciated. Evelyn Landry, RN, IBCLC, RLC (337) 289-7227 Wk (337) 288-5719 Cell Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome