I have a mother who is allergic to erythromycin, pencillin, sulfur, and
Keflex.  Mother had first mastitis at one week. Went to her OB and was put on
an antibiotic which was not compatible with nursing and told to pump and dump
for 10 days. She was told by her OB that she got the mastitis from a crack in
her nipple. She came down with a second mastitis just days after the
antibiotic was finished, the OB put her on a second course of the same
antibiotic.  From the amounts she was pumping, we (my associate and I) felt
she had an oversupply problem (5-6oz per pumping).  She used cabbage leaves
and pumped less time each pumping and had the supply down to 2.5-3.5oz per
pumping at the end of second antibiotic.  She came in to have help on
positioning and attachment. Baby latched and nursed beautifully.  I noticed
that nipples were very pink for a mother who had been pumping for three
weeks.  I suspected yeast.  Started topical application of lotrimin, went
over possible causes of breast infections, and watching for thrush in baby.
 I was concerned that nipples would become worst.  Within two days, nipples
became too painful to put baby to breast.  Mother went back to nursing and we
got OB to start her on Diflucan 150mg for one week.  Two  days later, mother
has third mastitis.  OB put her on Zithromax, mother back to pumping and
dumping.  OB took her off Diflucan till finished with the week course of
Zithromax.  HELP, does anyone know of an antibiotic that this mother could
take that would be compatible with breastfeeding and that she isn't likely to
be allergic to?  Any other suggestions??????? I feel she has a duct-yeast
infection and the Diflucan is the most important way to treat the problem.
 OB doesn't seem to get the big picture of what is happening here. Any
suggestions would be appreciated.

Pat Lindsey, IBCLC , LLLL