Hi Ann. This certainly sounds like it is worthwhile re - contacting this lady's physician again. It sounds to me like a typical Yeast Infection. I have never yet seen a nipple with white spots, but have found most thrush infected mothers have the light pink [pinker than is usual even in a fair mum] nipples with a pearly shiny look, and the awful pain you describe [in varying degrees]. I have found that in these cases topical treatments are of no help and an oral medication is required. Many physicians forget to treat the baby also, especially when they can't see any physical evidence of thrush, but it has been my experience that the mother's condition does not fully clear up until the baby is treated also. I have found Nystatin to be fairly ineffectual in most mums with a deep seated yeast infection and generally recommend that they ask their physicians about alternatives. It is my feeling that the redness you describe was incidental to the problem, probably a blocked duct or two, which she has cleared with pumping or feeding. In the yeast infections I have seen, there has been no visible breast signs, only the nipple symptoms. I think that this is one of our "mis-informed" doctors.........Quote - "the pain is coming because her breasts are heavier with the milk". Does he think all breastfeeding mums should have pain because their breast are full? We don't stand a chance of encouraging mums to breastfeed if they think they are going to suffer pain because they have the "weight" of their milk to carry around!! [maybe its the weight of the milk that makes our breast tissue less pert after pregnancy and breastfeeding.] Just a thought!! My mind boggles at the possible cartoons!! Brenda Donnelly RGON NMAA Counsellor Brisbane Australia.