Well, I am not too sure what "chronic mastitis" is.  I do not believe
that anything like this has been documented, and I have only seen an
occasional mother who *might* fit into the definition.

Long standing, unresolved mastitis is sometimes a breast abscess.  If
the mother has a hard or firm area in the breast which is very tender,
it could be an abscess.  Diagnosis made by aspiration, an office
procedure.  Treating forever with antibiotics will not resolve an
abscess.  It needs surgical drainage, but the mother does not have to
stop breastfeeding even on the affected side.

However, I think that Candida can cause recurrent blocked ducts.  I
have no proof for this either, but I think it is the real thing.  I
would take the mother off antibiotics and put her on fluconazole.  The
baby could go on fluconazole as well.

Jack Newman, MD,FRCPC