> I was thinking last nite that I wonder if the incidence of mastitis would go
> down (a nice prospective study to do?) if we instructed moms in prenatal
> classes and in bf advice to WASH THEIR BREASTS AND NIPPLES WITH A
> MILD SOAP (Laurie)
According to WHO's Mastitis, causes and management,(Geneva 2000) mastitis is
primairily caused by milk stasis, which may or may not in a later phase be
accompanied by infection. Infection as a primairy cause is rare in most parts of
the world. I can however imagine that in a highly medicalised surrounding with a
high antibiotic use and thus a high resistance rate, mastitis due to infection
may be increased.
Washing the breasts in that case would IMO not clear the cause of infection, but
merely the spreading. And indeed I do think that cleansing the breast with soap,
even a mild one, will have a negative effect on the antibacterial properties of
the nipples and areolae.
What might help on the other hand in these high risk environments might be to
keep the baby close to mom and have all other people touching baby or mom have a
good scrub.

Gonneke van Veldhuizen, IBCLC, living in Maaseik, Belgium
http://www.users.skynet.be/eurolac
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