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---- Kika Baeza wrote ----
>Hi all,
>
>In women with chronic breast pain (breast pain lasting more than one week,
>with no visible signs of inflammation), according to the literature one of
>the possible reasons is an infection, usually by S aureus, according to
>some authors also to Candida albicans (
>
>*Betzold CM Results of microbial testing exploring the etiology of deep
>breast pain during lactation: a systematic review and meta-analysis of
>nonrandomized trials.J Midwifery Womens Health. 2012 Jul-Aug;57(4):353-64).*
>*So here is my question. Once I´ve ruled out other causes of chronic/deep
>breast pain ( such as *referred pain from nipple trauma secondary to an
>inadequate latch, pectoral/cervicothorathic muscle contraction secondary to
>strain or unergonomic breastfeeding positions, or emotional cause), I ask
>for a milk culture. However, I have trouble with the results. According to
>the most popular lab in Spain, any single colony of S aureus is
>pathological, and for other microorganisms anything beyond 700 CFU is also
>considered pathological. This, by all acounts and all I´ve read, is a very
>very low limit, meaning we are looking at normal milk, not infected milk
>(and it also means that a lot of women are getting antibiotic treatment for
>no reason).
>
>On the other hand, the NICE Clinical Guideline CG93 revised in 2014, states
>that milk for donation is considered contaminated if the counts are
>above 100.000
>CFU/ml of total microorganisms, 10.000 CFU/ml of Enterobacteriaceae or
>10.000 CFU/ml of S aureus.
>
>
>In my practice when I decide to treat a mom I go by the NICE numbers and
>the clinical symptoms, but the NICE numbers are really about what milk
>should look like for donation, not about chronic breast pain.
>
>
>So I ask you all, what microbiological limits do you use to consider a
>mother has an infection?
>
>
>Warmly (veeery warmly) from Spain,
>
>Kika
>
>
>--
>Dra. Carmela Baeza
>Médico de Familia
>Consultora Certificada en Lactancia Materna IBCLC
>www.centroraices.com
>http://www.facebook.com/Consulta.Lactancia.Raices
><http://www.facebook.com/pages/Centro-de-Atenci%C3%B3n-a-la-Familia-Ra%C3%ADces/274415189309122>
>
>Autora de "Amar con los Brazos Abiertos"
>http://www.amazon.es/Amar-con-los-brazos-abiertos/dp/8426904688/ref=sr_1_1?s=books&ie=UTF8&qid=1420813499&sr=1-1&keywords=amar+con+los+brazos+abiertos
><http://www.ediciones-encuentro.es/libro/amar-con-los-brazos-abiertos.html>
>
>Comprometida con el Derecho a Vivir
>http://derechoavivir.org
>
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