PMID: 9429366Jan 16, 1998Paper

Long-term treatment of a breastfeeding mother with fluconazole-resolved nipple pain caused by yeast: a case study

Journal of Human Lactation : Official Journal of International Lactation Consultant Association
V Bodley, D Powers

Abstract

This case follows a breastfeeding mother with cracked nipples undergoing antibiotic treatment (dicloxacillin) for mastitis. Nipple candidiasis also presented with burning, stinging pain radiating from the nipples into the breast, lasting throughout feedings and beyond. Over a 7-week period, the asymptomatic infant was treated with the oral antifungal, nystatin. After other antifungal treatment regimens (oral nystatin, tristatin ointment) had been deemed unsuccessful for the mother, the physician prescribed fluconazole (200 mg loading dose plus 100 mg/day for 15 days) which reduced, but did not eliminate, the nipple yeast and accompanying pain. Fluconazole was continued for an additional 30 days (200 mg/day) for a total of 6 weeks of treatment with this medication. Concurrently, a topical yeast medication (tristatin ointment) was used for a total of 8 weeks on the nipples/areola, after which the overt pain was resolved. Although the mastitis resolved after 1 week, the cracked nipples did not completely heal for several months. During the initial 3 weeks of treatment, neither over-the-counter pain medication nor acetaminophen with codeine relieved this mother's pain. Hydrocodone bitartrate and acetaminophen (10/650 mg/tablet) (Lo...Continue Reading

References

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Citations

Jul 25, 2000·Journal of Midwifery & Women's Health·P Tait
Jul 31, 2007·Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine·Philip O AndersonSteven S Rossi
Dec 3, 2014·Child and Adolescent Psychiatric Clinics of North America·Hilary RoweThomas W Hale
Dec 14, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Robert G Hendrickson, Nathanael J McKeown
Nov 28, 2012·Pediatric Clinics of North America·Hilary RoweThomas W Hale
Feb 18, 2004·The Breast : Official Journal of the European Society of Mastology·A R Carmichael, J M Dixon
Mar 15, 2002·Obstetrics and Gynecology Clinics of North America·Gail K Prachniak
Apr 25, 2018·Wiener medizinische Wochenschrift·Arabella FischerKlaus Ulrich Klein
Feb 24, 2011·Obstetrics and Gynecology·Jason B SauberanLisa M Stellwagen
May 8, 2020·Clinical Pharmacology and Therapeutics·Jonathan Zipursky, David N Juurlink
Jan 12, 2001·Journal of Human Lactation : Official Journal of International Lactation Consultant Association·V Bodley, D Powers
May 12, 2021·Deutsches Ärzteblatt International·Susanne Schrey-PetersenHolger Stepan
May 26, 2021·Clinical Pharmacology and Therapeutics·Jonathan S ZipurskyDavid N Juurlink

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