We were talking last week about the studies that have used sodium levels as
evidence of mastitis (Semba et al).
My August JHL has just arrived (which is a pleasant surprise as I usually
receive it at least a  month later) and there is a good letter from Valerie
McClain about this. The authors reply and say that they don't believe the
high sodium levels are associated with weaning in their studies.
"Longitudinal analysis from Malawi shows that an episode of elevated sodium
concentration in breast milk was usually followed by a normal sodium
concentration in breast milk, further suggesting that the episodes of
increased breast milk sodium concentration reflect an episode of mastitis
and not weaning".
they go on to say: "... there is a need to characterize the epidemiology and
microbiology of mastitis in developing countries."
mmm, why add the "in developing countries"? Sounds like they are
hypothesising differences between mastitis in developing countries and more
affluent countries. Why not investigate US/UK/Australian women for
"subclinical mastitis" as well? Of course, their idea is that mastitis may
be a key risk factor of HIV transmission. It seems it has taken the HIV
epidemic to get scientists interested in mastitis! Perhaps my idea of an
international meeting about mastitis may come about one day (in my fantasy
it will be by an Italian lake, like the Bellagio consensus meeting on
LAM...)
Otherwise, the rest of this issue doesn't look very interesting (IMNSHO!).
Good luck to everyone sitting the exam ;-) Remember it is an entry level
exam and the questions aren't as detailed as where to position the nipple
when the baby has a cleft palate. Just keep in mind that you are answering
the questions as a LC (not as a doctor / lay counsellor / etc).
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia - who had great fun at the IBLCE
exam committee meeting last October!

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