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Mom had a breast infection that was treated with dicloxacillin and seemed to resolve (fever, pain and redness gone) but she had a persistent plugged duct with reduced milk transfer.  One month later, pain was again increasing and her breast became swollen and red.  She went back to physician and was given a shot of penicillin and a prescription for penicillin.  When she told me about the penicillin, I informed her that most breast infections are from penicillin resistant staph and that another antibiotic would be better.  She saw another physician who agreed that penicillin wouldn't be effective and prescribed augmentin.  She is to go back to the physician in three days for follow-up.

I saw her today and she does appear to have a walnut sized abscess with significant redness on the entire lower inner quadrant of the breast.

Is it possible for this to heal without draining the abscess and is it reasonable to wait three days to treat further?  Does anyone have experience with antibiotics that work best for mastitis?  I have provided the ABM mastitis protocol to the mom.  I also gave her an article from ABM about a case study that lists some antibiotic choices.

I am concerned that the physicians are not culturing her infection in order to find the best antibiotic.  I want to know if I should be encouraging the mom to ask for more aggressive care.  Also any other advice would be appreciated.  I have never worked with a mom whose breast infection developed into an abscess.

Laura Spitzfaden LLLL, IBCLC

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