I've had a similar situation this past week and am lucky enough to work for a 
health care system that values collaborative care. A mom with 7 month old 
twins who pumps at work reported a decrease in milk supply from one breast, some 
pain and tenderness in that area of the brest but nothing indicative of 
mastitis or thrush. A few days later, she is getting some blood in milk from that 
side. Immediately I called the Nurse Practioner at the OB office and suggest an 
ultrasound and milk culture, thinking it might be an encapsulated infection. 
They were happy for my input, hadn't considered those diagnostic ideas and got 
the mom in within 24 hours. Anxiously awaiting the results.
Mary Kay Smith, RN, IBCLC
Canton MI USA near Detroit

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