I have been working with a mother with a 7 month old baby who has had
mastitis almost every month since the baby was born. The first 3 cases
were treated with Keflex, but time between episodes kept decreasing with
increasingly severe symptoms. During month 4, and the 4th episode,
doctor began treating with Augmentin. Mother ended up with a 28 day
course of treatment. Problem seemed resolved, mother went about 6 weeks
with no recurrence, the longest problem-free period yet. 2 weeks ago,
mastitis occurred again. Mother is just finishing up a 14 day course of
augmentin.
Mastitis always occurs in left breast, towards the armpit. Starts off
with a sore, red breast, mother immediately begins all the standard
self-help treatments. Flu symptoms begin shortly thereafter, accompanied
by red streaks on the breast. Around 12-24 hours after onset of initial
soreness, mother is able to detect a formed, dense mass in the breast.
Mass typically occurs in basically the same position, although the
soreness may present in slightly different locations.
At last doctor visit, he drew blood to check her immunities and did a
CA125 test for cancer cells. Everything came back okay. Milk was not
cultured. Doctor is at a loss as to what to do next, and would welcome a
consultation with anybody who may be able to give him some guidance.
This mother also has a problem with severe postpartum depression (was on
Zoloft but stopped after baby began having tremors), fatigue and lack of
sleep (her baby and 4 year old daughter require very little sleep, and
get her up many times during the night), lots of job-related stress,
some marital stress over her desire to quit work and husband's desire
for her to keep working so they can maintain their current lifestyle.
I don't know what else to tell this mom to get the recurrent mastitis
problems resolved. The initial case began 1 week after returning home
from the hospital. The doctor thought maybe she picked up some bacteria
in the hospital. [My brother picked up many staph aureus infections
while in and out of the hospital with kidney failure. It could only be
treated with vancomycin.] Would vancomycin be a reasonable antibiotic
for the doctor to try next?
If anybody has any useful information that you could share with me, I
would be most appreciative. Or if anybody has special knowledge and
would be willing to consult with this doctor, can you please email your
phone number to me so I can pass it along to him? I just hope this mom
is not doomed to have a breast infection every month or 2 for the
duration of breastfeeding (she plans on extended nursing like she did
with her first).
Thanks,
Amy
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* Amy Shelton, mom to Abby (6/93) and Christopher (5/96)
*
* LLL Leader, ALLE for LLL of AL/MS/LA *
* LLL of Huntsville: http://iquest.com/~ashelton/homepage.html *
* A Mother's Love (sales/rental of breast pumps and accessories): *
* http://iquest.com/~ashelton *
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