I posted a couple of weeks ago about a mom I've worked with who had
bilateral sore breasts that were also hard. There was redness on the lower
halves. Since oversupply was a question, we worked on that and brought her
down to a nice, soft state. Concurrently, NP diagnosed mastitis, and mom was
put on Augmentin. Between the two, 80% of the soreness and redness cleared
up, but not all, so she was put on Keflex. No improvement. When she went
back again, MD then told her to wean.

Mom does not want to quit, so we continue to pursue answers. There is a
"shadow" of redness that still extends a little outside of the areolar
margin. No palpable lumps, soft tissue, breasts are always sore in this
area. Someone suggested culturing for beta strep, milk sample with mom and
naso and oropharyngeal cultures with baby-- after the first 24 hrs, nothing
has cultured so far. Mom cannot take ibuprofen because of a former bladder
cystitis condition (probably secondary to chronic high dosages of ibuprofen
for menstrual cycle pain during teen and early 20s).

If we culture nothing of significance, what next? Could she "just" be
sensitive? But if so, why the slightly visible redness if it isn't a mild
chronic mastitis?  Why did most but not all clear up?  I'm not sure where we
should go next....... suggestions?

Lisa Marasco IBCLC

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