Oh Kika, that's absolutely shocking!  I would put 
the "findings" down to persistence of really 
outdated policies and practice that didn't value 
breastfeeding.  I'd love to know how long the 
mothers and babies were followed up, how on-going 
lactation/breastfeeding went, if it was 
successful (if the baby thrived without supplements) etc etc.

I believe that mastitis is just about preventable 
if everyone jumps around from Day 4 - 9 to ensure 
that the breasts are extremely well drained 
(preferably by baby, but if not, then manual 
expression or a pump) .... but if it occurs, then 
what seems to work best is super-drainage and Abx 
after 24 hours if there is no resolution of symptoms.

Whenever I've worked with a mother with an 
abscess there's _always_ a history of persistent 
engorgement/induration which was just left.

I do think that cabbage leaves on engorged 
breasts seems to work to calm down over-supply a 
bit - accompanied by expressing/pumping/lots of 
breastfeeding - but really, progesterone 
gel??  I'm sure it would work, but do you really 
want to suppress lactation, or just to manage it? 
Why do we mess with a mother's hormones so much 
without a thought? I have a little case history 
of one which was published in the Central African 
J of Med where estrogen patches were used to 
treat postpartum depression and definitely worked 
(baby didn't gain and newborn jaundice just went 
on and on).  Bromocriptine depresses prolactin 
levels thus suppressing lactation, but has other 
horrible side effects - severe risk of depression 
and I've had mothers describe how they had to 
crawl to the loo, rather than walking because 
they were so dizzy.  And besides which 
bromocriptine has been contraindicated for new 
mothers for about 20 years now due to the risk of death or stroke!

I'll be interested in others' comments.

Pamela Morrison IBCLC
Rustington, England
--------------------------------------------------

Date:    Wed, 16 Dec 2015 17:00:21 +0100
From:    Kika Baeza <[log in to unmask]>
Subject: Suppression of breastfeeding to treat mastitis?

Hi everyone,

I´ve just come across the abstract of this article, and I must say I am a
bit shocked at the conclusions.

​My librarian has not been able to access the article. Has anyone read it?

J Matern Fetal Neonatal Med. <http://www.ncbi.nlm.nih.gov/pubmed/26513602#>
2015 Nov 30:1-5. [Epub ahead of print]
Management of mastitis and breast engorgement in breastfeeding women.
Pustotina O
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Pustotina%20O%5BAuthor%5D&cauthor=true&cauthor_uid=26513602>
1.
Author information <http://www.ncbi.nlm.nih.gov/pubmed/26513602#>
Abstract
OBJECTIVE:

To identify the best management approaches to mastitis management in
breastfeeding women and heavy breast engorgement in the early postnatal
period.
METHODS:

We compared various international guidelines and reviews on mastitis
management in breastfeeding women and breast engorgement treatment.
RESULTS:

Effective milk removal is recommended as a first step in mastitis
management. Active emptying of the breasts can prevent mastitis development
in most cases. If it fails, antibiotics should be administered for 10-14
days with continuing breastfeeding. Russian guidelines recommend antibiotic
therapy during 5-7 days with temporary bromocriptine-induced breastfeeding
suppression. In case of heavy breast engorgement after lactation is
initiated, Progesterone-containing gel can be administered. Application of
the progesterone-containing gel on the breast skin improves swelling, and
reduces engorgement and tenderness in 15-20 minutes.
CONCLUSIONS:

Antibiotics with temporary suppression of breastfeeding are more effective
than with continuing breastfeeding in mastitis management. The
progesterone-containing gel is recommended on the 3rd-4th days after
childbirth in heavy breast engorgement to prevent mastitis.
​


-- 
Dra. Carmela Baeza
Médico de Familia
Consultora Certificada en Lactancia Materna IBCLC
www.centroraices.com
http://www.facebook.com/Consulta.Lactancia.Raices
<http://www.facebook.com/pages/Centro-de-Atenci%C3%B3n-a-la-Familia-Ra%C3%ADces/274415189309122>

Autora de "Amar con los Brazos Abiertos"
http://www.ediciones-encuentro.es/libro/amar-con-los-brazos-abiertos.html

Comprometida con el Derecho a Vivir
http://derechoavivir.org
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