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Date: | Tue, 1 Oct 1996 07:32:00 -0500 |
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Hello to all. Boy, this is my week to have weird and scary cases. I saw a
G2P2 mom today with bilateral mastitis. Baby is 6 wk pp. First incidence
of mastitis at two weeks pp in left breast. Treated with antibiotics for 10
days; breast stayed inflamed for a week even on meds. Both nipples have
been cracked and rather pus-y since early pp. Yeast around that time. Baby
treated with Nystatin, mom told to paint nipples with baby;s meds. Mom is
Group B strep carrier. Current episode began 3 days ago. Ceftin (which is a
cephlasporin, I think) was phoned in same day. This time both breasts
affected. Both appear scalded, and have stayed red even tho mom has been
faithfully taking meds. I observed Peu d'orange on left due to edema.
Neither breast would pump, even after application cold packs. Mom taking
ibuprofen. Dr. has not seen the mom -- Nurse Practicioner saw her today.
Baby was very fitful when I saw them late today. Struggled at breast and
would not nurse well (maybe milk tastes bad, maybe baby ill). Baby not
febrile, but was still fussy sev. hrs later when I called.
So you tell me if I am over-reacting? I told her I was concerned that
bilateral mastitis could be a strep infection. I mentioned (without getting
specific) that I would not recommend continued nursing until pedi cultures
child's throat and says baby is ok. I also suggested she insist on MD
seeing her. Also to treat nipples topically, and do drug sensitivity to
make sure of right meds.
I have never seen bilateral mastitis once engorgement phase is over. Any
one have any ideas?
Barbara
Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html
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