Dear Lactnet
Please offer your expertise and opinions about this mom's situation.  I am out of my league, pardon the pun, about this one.
Mom with first baby 6 weeks old, bw 8lb 5oz.  At five weeks, baby weighed 9lb 3.5oz--a pretty low gain.  Mom was sick after birth from hemorrhage (she lost more than 1000 units of blood:  placenta tore and needed to be manually expressed).  Baby did not nurse until day 9 with mom expressing and feeding milk to baby while she worked to get him awake, latched and nursing well.  She says he's been nursing exclusively since, every 2-3 hours with a 5 hour stretch at night.  I think that the baby's low weight gain is due to her limiting feeds to 10 mins a side.  Baby was pooping pea green.  A week ago--after the doctor appointment and weight check--she decided to let baby finish the first breast first and at that time noticed that his poops started looking more like regular mustard-seedy breastfed poops.   She is looking to see a better weight gain, now.  But that's not why she called.
Here's the problem she called me about--
Mom just finished up a 7 day course of abx (don't know name) for mastitis in one breast.  Toward end of course, mastitis flared up in second breast, so her doctor has doubled her abx dosage and started her on a second 7-day course.  Even though her first mastitis was relieved with antibiotics almost immediately, her second breast lump is still there and still sore.  She called me asking how not to let mastitis happen again.  She gets sick with a fever immediately, with no warning.  Culture the milk?  
As we talked, she told me she had mastitis during the second trimester of her pregnancy.  At that time, she was prescribed abx for two weeks, then a stronger abx for another 2 weeks when it didn't go away.  I also learned that when she was 12, she got hit in the breast while playing basketball.  A lump developed.  Aspiration showed clear fluid.  Lump hardened and didn't go away for 20 years!  Never had a mammogram.  
I went through all the information on recurrent breast infection in the BAB with her.  No hits on anything other than the injury--and probably the limited feeds, which we also talked about.
What else would you tell this mom, who by the way is returning to full-time work tomorrow?
Thanks,
Diane, LLL
Florence, VT


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