Permission to post: working with a mother of a 3-month-old infant who presented to her MD 2+ weeks ago with SEVERE burning pain in the superior portion of her L breast. No fever, redness, swelling or firmness of breast. She was put on Augmentin for 2 weeks and the burning stopped. She finished the prescription 3 days ago and she has started to have intermittent burning again in the breast with a raw feeling nipple. Her milk supply did not decrease during this episode. Pumping is the only thing that relieves the burning. Infant continues to nurse one side each feeding q 3 hours on the weekends. Mom pumps q3 hours while away from her at work. She was not on antibiotics previous to the first episode. I instructed her to continue 800 mg ibuprofen q 8 hours (as instructed by MD) for a few more days, try heat on the breast when burning is starting (has noticed an area of white blanching on nipple intermittently) and considered lecithin, in case it is a plugging problem. I am wondering about a possible resistant bacteria and I am wondering if there's a standard protocol for culturing milk to r/o staph that I could share with her MD? I appreciated any suggestions. 

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