Hello

I have here the mother of a 20 months old. Since 5 weeks, she has a
 mastitis ». She contacted me by phone two weeks ago about that. She is an
experimented breastfeeding mother, and took the « good measures » at the
beginning (frequent brestfeeding, and so on). No improvement. Has seen a
doctor, who give 8 days antibiotic. No improvement. Give another course of
antibiotics, no effect. Has just moved since 2 or 3 days, and sure is very
tired. She has on the breast a large (almost half of the breast) hard and
red zone, and a little fever since a few days. I urge her to see again a
doctor, for a general and local evaluation.

Phone me again today. Has seen a doctor, very supportive for breastfeeding,
not at all anxious about the situation, give « tonic » treatment and no
antibiotics ; recommand cabbage applications and mud-packs. The global
situation seems better to the mother ; the breast is now soft, excepted a
little area which is indured and violine. And today, she has a wound in this
area ; no pus, but very painfull. No other sign of abcedation, good general
condition, no fever, no pain inside the breast (only the wound hurt), no
 ball » inside the breast. Biologic evaluation shows signs of
inflammation/infection, but not important. I am puzzled (and very difficult
when having the mother only at phone). I recommand her to see the doctor
again as soon as possible, and ask for a mammography or ultrasound.

Any ideas ? Thank you a lot.
Kindly
Francoise Railhet
Manager of the LLL France Medical Associates Program
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