When I work with a mother with recurrent mastitis I usually have the whole family cultured for staph and strep infections. Usually one of the other children or the woman's partner is an asymptomatic carrier. Throat and nasopharengheal (sp?) cultures are taken and then the affected person is treated. Prophylactic antibiotics may become useless if the mother is repeatedly exposed to the pathogen and resistance will build up. Last year I worked with a mother who had 7 or 8 bouts of mastitis. Her doc was very reluctant to culture the family and (of course) advised her to wean. She had been on prophylactics but (as usual) had quite a few break through infections and we were running out of antibiotics to use on her. Finally the doctor consented to culture the family and the mother's husband grew out naso-pharengheal staph. He was treated with oral and nasal drop antibiotics (along with a "no intimate contact" order for the duration of his treatment) and the mother has been free of mastitis for over a year. In one family I worked with the carrier was the dog! (I am NOT kidding.) Dogs often carry strep and pass it on to family members. Finding a carrier and treating him (or her)(If this is the origin of the pathogen) is preferable to the side effects and failures that many of us see with prophylactic antibiotics. Mary Jozwiak IBCLC, LLLL, AAPL Private Practice *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html