Hi Anne, Interesting case re the persistent thrush in the mother and nursing children. For persistent oral thrush, I have found painting nystatin oral suspension on the oral mucosa and tongue with a fat Q tip after every nursing works better than 1 ml qid. If this fails, I resort to ketoconazole suspension painted on twice a day for five days followed by some nystatin. Have you tried a combination topical steroid mixed with the antifungal or even a topical steroid alone for the mother's nipples? Perhaps the yeast is an incidental finding and the real culprit causing the mother's pain is a contact dermatitis or an eczema? Finally, what about the HIV status of this family? Let us know how this turns out. Shirley Gross M.D.,C.M., C.C.F.P. Edmonton Breastfeeding Clinic