Thanks Dr. Hirsch for reviewing this article.  Studies like this are very necessary to add to our beginning body of knowledge.  The most interesting aspect of the data to me was that 39% of those treated had no elevation in body temperature and only 27% had a body temp over 38.4. How then was the diagnosis made?? Previously, I had thought that the diagnosis of mastitis was made by the elevation in body temperature and the extreme malaise not just local symptoms. Breast pain was the most common symptom in this study. Was the diagnosis made on this alone? The range of ages of the baby was 3 days to 270 days. At 3 days were some women treated who merely had engorgement? It really does point out the fact that we really don't know what the process of mastitis is. Is it ductal infection or interstitial? Is it infectious or inflammatory? . When do you treat with antibiotics and when is an antiinflammatory agent with rest, fluids, and frequent nursing enough?
Carol L'Esperance RN, MSN, IBCLC Albuquerque, New Mexico

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