Have been speaking to a mom who was referred to me by another LC who was as
confused as I now am....

Baby is 3.5 months old, breastfeeding well, no problems (mom had not
breastfed first child as long as she wanted to, so she was very happy).

Mom developed a mastitis in her left breast, went to her MD who started her
on doxicillin, Advil (ibuprofen), frequent feedings, warmth at the breast,
rest, fluids, etc.  She had rented a breast pump, was breastfeeding and
pumping often when her baby wasn't interested in nursing.  It seemed to be
resolving, she stopped the, but continued the antibiotic.  

Three days later she developed a horrid redness and hard area on her RIGHT
breast from 6 o'clock to 11 o'clock...Dr. ordered Keflex (cephalexin) and
when she first called me, things were going from bad to worse, with lots of
pain.  The Dr. had ordered an ultrasound, which she was told showed "no
abcess".  At this point she just wanted to wean and stop the pain and
infection.

We discussed alternatives, she decided to continue breastfeeding and try
cold compresses to see if these helped.  

Two days later she called, very upset, now she was still in pain, still
swollen (though it was a smaller area), but now her milk supply had
reduced, and she saw no change in the lump whether the baby nursed or she
used the pump.  MD saw her the next morning ordered an ultrasound - she was
told "no blockage is visible".  The MD did increase the antibiotics and
encouraged continued use of Advil.  

Today she called again - has been back to the MD - she feels her baby is
now not getting enough milk, she chews on her hands after feedings - at
either breast.  The doctor stated this is cellulitis, and encouraged her to
continue on both antibiotics, but now has also prescribed Vicodin
(hydrocodone) for pain.  She does not feel the pain (2 on a scale of 0-10
now) justified her use of this, and said she'd rather continue with Advil
when needed.   I had suggested that she ask for a study of the breast milk
to try to better identify the cause, but the MD refused, saying there was
little likelyhood this would prove effective - that it is practically
impossible to do a "clean catch" of breast milk.  

Mom says the size of the affected area is now down to 6 o'clock to 9
o'clock, but no change in that area when she pumps or breastfeeds, and she
does not hear he baby swallow as before.  She offered a bottle of formula
after a nursing and she reluctantly took 2 ounces.   

She is open to natural treatments and asked me about the use of alfalfa. 
She also is planning to visit an acupunturist.

Due to my limited knowledge of herbal remedies, I went on the archives and
found alfalfa recommended for increasing milk supply together with other
herbs, so this does not seem like a problem in terms of risk to her baby. 
I did look up Cellulitis and found some information, but wanted to hear
from those of you who can provide me with some insight.

Another aspect of this situation:  the mom had been given fertility
treatment in order to achieve pregnancy.  I had also asked her if any
hormonal levels had been checked since she delivered and she said no, that
the MD had said they wouldn't be accurate as they would be affected by
lactation.

I'd appreciate input!  (Please copy to me directly as well as on Lactnet)
________________________________________

Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, CA
_______________________________________________________
What have you done to support breastfeeding today?

Que hiciste hoy para apoyar la lactancia?

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html