I am working with a mom who has a 5 week old, exclusively nursing, well  
developing, baby # 2. Everything going well, but mom developed mastitis on  
Saturday. OB called in a script for cephalosporin. He also wanted to give her  
parladel  because breastfeeding is "dangerous" for the baby when mom has  mastitis 
and the milk needs to be dried up ( his advice). She refused  that.
Her temp is still running 102.2 today, even while alternating taking  
acetaminophen and ibruprophen with the antibiotic. The area of redness is  spreading 
toward the outer areas of her breast-it was located near the areola on  
Sunday. She has tenderness, fullness, and it is extremely warm. She does have a  
small knot this AM near the edge of her areola.The baby is nursing on that side  
but not as well. Mom has typical "flu-like" symptoms. She is hand expressing  
some after the baby nurses on that side to keep it from becoming engorged, and 
 is using warm compresses, is on bed rest, and drinking plenty of fluids.  I  
am seeing her this afternoon.
My question is:
Dr Newman's book says he likes to use cephalexin for mastitis. What is the  
difference between that and cephalosporin? Is 3 days on cephalosporin enough  
time to start decreasing the symptoms? 
I had recurring mastitis with my third child but each time, I was ok by day  
2 and then would relapse about 2 weeks later. I was never ill over 2 days. 
After  the 9th time, I used antibiotics for  a 30 day course and it never  
returned. This is her first incident with mastitis with either child. Most  moms 
that I have worked with have not been this ill. She is an RN and she says  she 
has never been this "down to her bones aching ill". 
Any words of wisdom, advice??
Thanks.
Barbara Whitehead, BS, IBCLC, RLC
eastern NC

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