I agree with Barbara that :  "What we don't know about mastitis in humans
would fill a
textbook."

I recently saw the new LLL info sheet on engorgement.  it was interesting in
that it basically treated engorgement as what I would call the
non-infectious sort of masitits (to be fair, the handout concentrated on
early days' engorgement, but mentioned that it could happen at any time).
The differentiation between the two types of masitits (inflammation of the
breast) -- infectious, non-infectious, engorgement and blocked/plugged ducts
(is this simply *an* aetiology  (one of many) of mastitis?) seems to be done
differently by different authors, and discussed differently by different
practitioners.

And, if we add in this category of sub-clinical mastitis -- which I am wary
of for several reasons -- we are calling a whole panoply of conditions by
the same name....

(I am wary of the sub-clinical category because these papers (Willumsen et
al and several papers by Semba and various co-authors)  which point to it
seem  to have used milk samples and no clinical examination, so what does
that tell us -- thanks to Valerie for pointing this out to me.  Also, I just
wonder almost the opposite of Barbara, who is using the term in an effort to
help women who have pain which is not at the level of staph infection:  will
examination of milk become a marker for a condition which is not experienced
through any symptoms in women -- but who may then be told that their milk is
risky -- certainly for women diagnosed as HIV+ -- for their babies???)

I agree that this issue needs discussion.  One of my (many) jobs this summer
is to read the WHO document on mastitis thoroughly and think about these
issues.  I don't know what happened to the journal club idea, but it might
be interesting to try a topic based discussion....

Magda Sachs
Breastfeeding Supporter, BfN, UK

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