Patt -

I don't think we see this often - I've seen it only twice - but dairy farmers are apparently much more familiar with it, presumably because infections get worse in cows before they're recognized.  The same dairy scientist who told me it's a sign of mastitis also said that Staph aureus has "a coagulating factor" in it, which is why the milk can be clumped or clotted.  Yep, the clots dissolve after they've stood a while.

My two experiences: One was the mother who ultimately drove me to find a dairy specialist.  Sure enough, she had some exotic bugs in her milk that needed something other than standard mastitis treatment.  What was especially interesting is that she had had blobby milk from one badly damaged nipple with her first and we had never solved it.  She ultimately weaned to the unaffected side.  The blobs recurred with her second; made me wonder if she harbored a latent infection for 2 years between babies.  One of the blobs was about the size of a small, bloody egg yolk!  They would clunk into the bottle as she pumped.  She was given both standard mastitis treatment and treatment for  I-forget-what-other-bug(s).  Which organism(s) caused the blobs?  I guess I'd assume it was Staph aureus, but I don't know.

The other experience I had was with a woman who found mucousy strings that stuck to the flexible pump flange she'd been using.  When we switched to a hard flange, the mucus stopped immediately.  So it seemed more like a response to trauma than an infective process.  

Bottom line: blobs, clots and mucus are evidence of an unhappy breast, most likely from Staph aureus, but perhaps also from ongoing trauma.  The milk can't be bottle-fed unless it's allowed to stand for a period of time, during which the blobs disappear.

Barbara Wilson-Clay/Kay Hoover's Breastfeeding Atlas has a picture of blobby milk.

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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