Dear Paula,

My first question would be what type of bacteria was isolated from the abscesses.  Was it the same organism with each baby?  Where is the bacteria coming from?  Was mom treated with appropriate antibiotics for an appropriate period of time?  Is someone in the family colonized with this bacteria?  Are the infections preceeded by nipples trauma and if so, are the nipples being aggressively treated with topical antibiotics in addition to mom taking oral medicine? Does mom have hx of overabundant milk supply?

I think that the top priority in this case is to identify the probable source of the bacteria and deal with that first.  When mom breastfeeds, she needs to pay close attention to a good latch in order to decrease the possibility of nipple trauma which could offer a portal of entry for bacteria into her breasts.  She needs to empty the breasts frequently in order to prevent any engorgement.  If she suffers from an overabundant milk supply, this must be addressed quickly.  Any signs of infection should be treated very aggressively, both systemically and topically.

Other peripheral questions that come to mind.  Does this mom suffer from other infections on a regular basis?  Is she anemic or suffering from some immune system deficit?  Can she use supplements, herbs or medications to boost her immune system and/or decrease inflammation?

Two rounds of severe mastitis/abscesses are indeed serious.  She needs to consider a lot of issues and form a strategy that has a good chance of succeeding.  Good luck.  Let us know what happens.

Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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