I agree that the infective organisms may not be the only factors here. 
Stasis is a very important predisposing factor, and need not be cancer or 
scar etc.  And an abscess should be excluded with an ultrasound scan.

Anecdotally, and perhaps too simply for this list? My recurrent mastitis 
(six events in 3 months) was not a matter of a chronic or inadequately 
treated infection, rather of underlying predisposing factors. They began 
after I went back to work, and struggled to get enough milk expressed for 
the feeds I would miss.  With a period of time during the day with no feed 
or expression of milk, I had a couple of blocked ducts that progressed to 
mastitis.  Also, I may have traumatised my breasts during my efforts to 
express.  I also had one event that definitely followed wearing a tight bra. 
Another followed my baby's sleeping a long period at night.   By the sixth, 
I learned to feel the blocked duct early enough to nurse so frequently that 
it did not progress to mastitis....

Nan Jolly M.B. B.Ch. LLLL
Port Elizabeth, South Africa

> Culture the mother's milk and areola. Treat for 21 days.  Culture the 
> nares
> of infant and child and if positive treat with bactroban to the nose 
> monthly
> for 5 days.  Can follow up with low dose clindamycin or erythromycin daily 
> for
> as long as needed. Us is indicated in this situation as a cancer or other
> blockage can be the underlying cause.  much of this is in lawrence can 
> show to the
> OB.  But why work with the OB--a general or family practice doctor may be
> better.
>
> FYI, Had one mom with recurrance times 3 come back with Strep A on nipple 
> and
> Strep Agalactiae in milk .  Treated infant with amoxicillan.  Mom was on
> Ceftin.  Mom had a lump in same breast prior to birth. developed a bleb in 
> 3 weeks
> or so and large amount of mucous was expressed and lump got smaller. Chris
> Christine Betzold NP IBCLC MSN

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