I think your client may never have gotten rid of the original infection. The
antibiotics probably got rid of/masked enough to decrease symptoms and go
subclinical but, once off, the bacteria grew again and wham -- an apparently new
infection when it actually is not. I have known several mothers over the years
that had such, although perhaps their's were caught a little earlier. If you
have the Drs. Lawrence book, Breastfeeding a Guide for the Medical Profession
(5th ed.), go to p. 277, but go over p. 281-282 very carefully. Prescribing the
"wrong" antibiotic because the bacteria hasn't been properly identified,
prescribing it for too short a term, and/or skipping doses because one forgets as
one feels better may all contribute.

I've known a couple of moms who were very prone to recurrent infectious
mastitis and their docs prescribed an antibiotic at low dosage, which they took for
several weeks to months after the fever and other acute symptoms went away.
(This was after culturing and working on other aspects of recurrence first.)
KKG

Re : Lactnet message << My client called at about 10 days PP.   She had had a
round of mastitis with antobiotics.   the mastitis cleared, she finished the
antibiotics were
finished, I counselled her on emptying the breasts well, checking for hard
spots,
redness etc.   Baby seemed to latch well, gain well, eat well. and have
plenty of
wet/poopy diapers.   Bammo, 3 days later, mastitis with fever of 102F, flu
like symptoms etc.   Her DR. RX'd more antibiotics and it all cleared up
again,
only to flare up again, this time she rode it out for 48 hours W/O antibiotics
and felt better.. The same way she felt after 10 days of the RX.   Then it
came again, also for 48 hours.   Applied heat, showers, pumping after BFing
and
a good latch with a thriving baby.   This time she developed a fairly tender
lump.. I thought, a-ha, it's a plugged duct, that has never cleared.   I
referred her to a Breast specialist (oncologist) who is also pro
breastfeeding.
(She really helped another client).   The Dr. said it was not a duct because
it
wasn't painful enough.   She ordered a Sono for the next day.   The sono was
done and a lump was found and biopsied immediately.   The results came in
tioday and are NEGATIVE.   But it seems the biopsy triggered a really bad
case of
mastitis to the point where she was admitted to the hospital for IV
antibiotics
and Morphine for the pain.   She pumped for 15 minutes, every 3 hours, all
thru the night after the procedure.  Still she ended up sick as a dog.... They
have the infection under control and she is pumping but the DR. is
recommending
weaning as soon as this is all cleared up.   Needless to say, the poor mom is
at her wits end and does NOT want to go thru mastitis again.
Any one seen this before?  >>

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