Linda Pohl describes a situation similar to what Marie Davis recently
described with clumps of material (debris?) appearing in pumped milk of
women with severe engorgement, plugged ducts and wounds on the nipple.  No
febrile sx but def. sx of inflammatory mastitis in both cases.  I speculated
this may be pus draining into milk which clots up in globules which live
cells engulf to manage and digest, resulting (in Marie's case) in milk which
looks normal (no more clots)  after a short period of storage. (Marie:  Was
the storage in refrig. or at room temp?) Linda P. asks whether I think pus
would clot up in milk.  I have no clue.  I'm guessing all the way here.

 I suppose there could be other mechanisms, but what would they be?  We know
sodium  content increases in milk when women are engorged, mastitic or
weaning.  Would this elevation in salt content create some tendency of fat
globules to adhere in pumped milk to form these clumps? Adding salt to hot
gravy doesnt make my sauces clump. Salt tends to be alkaline, and it is
acidity which causes curdling of cow milk. (Like you can't add cream to hot
tea with lemon or the cream curdles)

 Does increased heat in the breast cause some sort of curdling?  I've heard
grandmothers talk of severe mastitis yrs ago which resulted in their milk
"curdling".  Is this remark an artifact only of mismanagement and
misinformation given to these women, or does it reflect an observation of a
phenomenon related to what Marie and Linda are observing?

 You make cottage cheese by adding bacteria to milk -- this causes curdling.
I still vote for the idea that bacteria is doing it.

Ed Newton, an OB/Gyn friend of mine and I have been recently discussing how
very little there is in the clinical literature on mastitis.  There aren't
even very many descriptive case studies.  So we need to get busy and write
up cases.

I suggest that some of our colleagues who work in universities ask friends
in the vet colleges what the bovine literature says about this phenomenon.
It's sad, but I bet there is more research in dairy herds on mastitis than
there is in women.

Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin, Tx
Owner LACTNEWS On-line (the Conference Page)
http://moontower.com/bwc/lactnews.html