Pamela writes:



This little review will not alter my experience and observation of 
working with mothers who get mastitis which has shown me that if you 
catch engorgement and plugged ducts early enough (within 24 hours of 
the first Sx) and resolve them very promptly with frequent and 
thorough breast drainage, then mastitis should be almost entirely 
preventable without the use of antibiotics.  But if these conditions 
are left - and the longer they're left the higher the risk - then 
treatment with an appropriate antibiotic (and you can culture the 
milk to find out what that is) _and_ continued thorough breast 
drainage can almost always prevent mastitis progressing to 
abscess.  On the other hand, when mothers don't know what to do and 
when doctors delay prescribing, then the risks of lactation failure 
and abscess, with much pain/suffering and disastrous consequences to 
everyone - are high.  Consequently, my mastitis care plan would 
include daily face to face follow-ups until it can be _seen_ that any 
fever, pain/tenderness, inflammation and induration are resolving, 
and prompt medical referral for advice about antibiotic therapy, or 
repeat therapy, until I know it's quite over - irrespective of some 
little Cochrane Review of 125 subjects!


 Pamela,
I agree with your comments about how reviews are done and the risk of relying too heavily upon them. OTOH, there is no 
lack of evidence as to the risk of using abx in the human body--abx are far from benign and should be avoided if at all
possible. What troubles me is that so many LCs seem unmotivated to learn very simple alternatives to abx, the use of which, 
in my experience has never resulted in progression to abscess. Why in the world would it be preferable to trash the gut--
which is the center of the immune system and home to the enteric nervous system when you could simply use a homeopathic 
remedy and some castor oil?? In my experience, I have seen a zero failure rate with this approach.


 Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network, LLC
 


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome