Hi there,

I am also from New Zealand so am familiar with the treatments offered.  I tend to find fluclox needs to be 1gm stat, then 500mg 6 hourly for 4 days then 8 hourly for a further 4 days.  Along with something like voltaren to help with the pain and settle the inflammation.  If a woman is not getting significantly better in several days then something is wrong.  I would be thinking abscess or galactacele.  Either way referral to a knowledgable breast physician is beneficial along with ultrasound.   I guess ruling out any nasties might be necessary too. And therein lies the problem - accessing a skilled person on the public health system who has the right knowledge and experience.  Usually this person is only available  (urgently) under private health and near a metropolitin area.

I would also be doing milk cultures and watching for MRSA.

A colleague  (LC) and I have experienced similiar poor responses to antibiotics with mastitis in the last year or so.  One turned out to be MRSA and another 2 cases mystified us for weeks.

I wonder about the overuse of panadol at the first sign of pain and fever.  I feel it may suppress the fever and symptoms for several days and not allow the body to "declare itself".  I certainly feel this is true with children and ear infections which is why some children end up on a constant cycle of ear infection/panadol/antibiotics for months (and sometimes years !).

I'm curious about the ice before pumping - I always thought it would be heat first.  Happy to be reinformed!

I always find it handy to talk to the local microbiologist at your lab (after the milk samples are in) to see if they can shed any light.  They are usually very happy to be helpful.

good luck
Karen Palmer

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html