Hi Rita!

In our neck of the woods women with recurrent mastitis often culture out MRSA. I believe the antibiotic most often prescribed is Clindamycin, not Dicloxacillin.

Holly McSpadden, IBCLC

Sent from my iPhone

> On Jan 15, 2015, at 11:40 PM, Todd & Rita Madden <[log in to unmask]> wrote:
> 
> Hello all,
> 
> 
>  I received a call from the mom of a 5 month old who is battling recurring, febrile, mastitis in her right breast (3 times in the past 30 days) treated with Dicloxacillin.  She states the baby nurses well and has since birth.  Her issue is with the pump.  She uses a double electric pump with standard size flanges and develops lacerations on her right nipple and areola.  She has used a larger sized flange and has minimized the vacuum setting but still gets lacerations.  These lacerations then begin to ooze and lead to mastitis.  She has tried Bacitracin at the first sign of them, but it doesn't help.  She heals with nursing and avoiding pumping, but she is working and desires to maintain her supply as much as possible.  She reports a history of removal of 2 fibroadenomas from her right breast and 1 from her left 7-15 years ago (when she was in her twenties) with a periareolar incision and states her right nipple is shorter/flatter than her left.  Thank goodness she is not having any issues with her left breast and she states it is producing about 75% of her total milk supply. It sounds like we need to address recurring mastitis and best ways to maintain supply.  She and I have discussed hand expressing at work.  What suggestions can I offer this mom?  What could be causing the one-sided lacerations?  Scar tissue? Thanks for your help. Rita, IBCLC
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