Oh dear...I was hoping nobody would ask for refs...now I'll have to do some
swotting.

The distinction between infective/noninfective was first made way back in
the year of my birth: Gunter, M  1958 : Discussion on the breast in
pregnancy and lactation.  Proceedings of the Royal Society of Medicine,
vol.51, pp.506-509.

Following that, the classic ref. is, of course, chap.6 'Breast infections?
or mastitis?' in Maureen Minchin's book 'Breastfeeding Matters' (Alma
Publications, Australia, 1985 - is there a later edition, by the way?)

The UK's own Sally Inch and Chloe Fisher (midwives and breastfeeding
specialists, based in Oxford) wrote an article for a general practitioners'
(family doctors') journal: Inch, S and Fisher, C  1995 : Mastitis:
infection or inflammation?  vol.239, Aug., pp.472-476.  They place great
emphasis on helping the baby to 'milk' the breast more effectively by
improved breastfeeding technique.  They also report on their own study
which found a relationship between the breast effected by mastitis and the
mother's handedness.

I appreciate that back copies of 'Practitioner' may be hard to get hold of
outside the UK; you may like to try the UK-based Midwives Information and
Resource Service on http://www.midirs.org - they have many 'overseas'
customers and supply literature searches and copies of selected articles
for a moderate fee.

The subject is also succinctly covered in chap.14, 'Painful breastfeeding',
in the book 'Breastfeeding: a guide for Midwives' by Dora Henschel and
Sally Inch (Books for Midwives Press, Hale, UK, 1996).  The authors
acknowledge the difficulties of differential diagnosis and the risk of
abcess in untreated infective mastitis.  They mention leucocyte counts as a
possible tool (used, apparently by vets. treating cow mastitis and
mentioned by Maureen Minchin, above).

I will try to track down some more recent references.  I read Siemian
Berghuijs' post with great interest; what has been published in your
country on the subject, Siemain?  I also note several posts on
infective/noninfective antibiotics/ibuprofen late last year - several
wonderful examples of the 'noninfective' approach but few specific
literature refs. (except for Chloe's, above! - which is why I hesitated to
write too much on the subject initially - thought you might all be fed up
with it...)

All good wishes
Hannah
National Childbirth Trust breastfeeding counsellor, UK
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