RE:  the mom with bitter milk who had "thrush" for 10 mo with first child
and has had it for months with #2,  in spite of diflucan and other
exhaustive hygiene and topical measures.  It strikes me that the diagnosis
is either incorrect or she has HIV.  These treatments should have worked by
now if a fungal infection was the problem.  The only way that would NOT be
the case is if this woman has an extremely compromised immune system.  The
symptom of deep breast pain without fever is a MAIN marker for untreated
bacterial breast infection.  Breast infections can render the milk bitter or
salty.  Also, mastitis in herd animals, and we think in humans, creates
extra lipolysis.  The break down of the extra fat over time may make
chilled, stored milk, esp. prone to bad tastes due to saponification. Due to
rampant thrush-phobia, mothers are discouraged overtly or subtly from
obtaining appropriate antibiotic tx for infectious mastitis.  A mother who
has had mastitis is at risk for laying down scar tissue which predisposes
her to repeat infections in current and future lactations.  The Sept. issue
of the Journal of Human Lactation (one of the absolute most jam-packed with
quality article issues the JHL has ever produced) has two important new
articles on mastitis, one by our own Lisa Amir and one by Verity Livingston.
Anyone who is advising a mother with breast pain who hasn't read these
articles is handicapped in their understanding of what that mother may be
experiencing.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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