>We talked a bit about the concept of inflammatory vs. infectious mastitis,
>but this woman had sudden onset of a temp to 102 F., chills and has a very
>red segment of her breast.

The reason that amoxicillin can help mastitis is that if it is inflamatory,
the anti-inflamatory properties of abx will reduce the inflamation. But so
will ibuprophen (not Tylenol) and Mom is not left with an unhealthy gut and
possibly yeast overgrowth in herself and her infant. If the mastitis is
staf infection, then one would not expect recovery with amoxicillin.

My protocol for mastitis is:

1) Ask about nipple health. If the nipples are not damaged and open, then
the chance of infective mastitis is very small. Treat for inflamatory
mastitis.

2) Take Ibuprophen--400mg--every four hours for 24 hours.

3) Put cabbage leaves on the red area of the breast.

4) Feed baby frequently with chin pointing toward the reddened area--the
blocked duct. If baby isn't feeding well use a good breastpump to drain the
breast.

5)Re-evaluate at 24 hours. If the mother feels better, continue with above
treatment for another 24 hours. If she is not better or is worse, then abx
are in order.

If in point 1) the nipples are badly damaged I begin the treatments, but
re-evaluate at 6 and 12 hours, bringing in the abx if symptoms so not improve.

Jack Newman has a mastitis protocol on the website <breastfeedingonlinelcom>

Pat Gima, IBCLC
Milwaukee, Wisconsin


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