Sorry to keep going, this topic has created a LOT of unnecessary difficulties in Spain... I would not wish it on any other breastfeeding community. The Patel el al study you note, Marsha, says that subacute mastitis is BREAST ENGORGEMENT AND FEVER. They then say: "Jimenez *et al*. 2015, carried out metagenomic shotgun sequencing of breast milk sample collected from 10 women with mastitis (5 from subacute mastitis and 5 from acute mastitis and 10 healthy-controls. Similarly to the results obtained from culture dependent studies, *Staphylococcus* (*S*. *aureus* in acute and *S*. *epidermidis* in subacute mastitis)... " However in the Jimenez study, subacute mastitis is defined as "shooting needle-like pain and engorgement". Therefore, these studies are giving the same name to two different clinical presentations!! In fact, they are comparing microbiological results from two different conditions, not the same one! These are not valid results, they muddle issues. Subacute mastitis is well defined in the dairy industry... However, cows cannot tell us whether they feel pain or whether it is shooting burning or needle-like. Therefore the definitions in dairy industry cannot be based on these symptoms. So, whatever subacute mastitis means in the dairy industry (which I do not know, I have not researched it) it can't be automatically translated into human pathology. I think that the terms we use must be helpful and clarifying. Using the term subacute mastitis for humans is not, at least at this point... For the last few years here, women with just about any type of breast pain, even with just low milk supply, have been tagged as having subacute mastitis (since there are so many definitions that any difficulty can be a subacute mastitis). Their milk has been cultured, and since something always grows, they are treated with antibiotics (although no one really knows what is normal and what is not in a milk culture). They are also treated with probiotics. So, we have a lot of breastfeeding women waking around with unnecessary milk cultures, antibiotics, probiotics, less money in their pockets and unresolved breastfeeding issues (because why look at a baby's latch when you can dish out a few pills?). I hope this helps you understand why I am so insistent on this topic! Hugs from Madrid Kika ------------------------------------------- Date: Wed, 28 Mar 2018 09:26:44 -0400 From: Marsha Walker <[log in to unmask]> Subject: Subacute mastitis Subacute mastitis is a well known and unwelcome visitor in the dairy industry. It has also been recognized and defined in humans. The bacterial diversity in the breastmilk differs between mothers with acute and subacute mastitis (Patel et al. Sci Rep <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5552812/#>. 2017; 7: 7804.) Probiotic therapy for any type of mastitis is in its infancy and has been explored in a number of studies and countries. While it may not yet be ready for prime time, it hovers as a potential addition to our choices of interventions. Marsha Walker, RN, IBCLC Weston, MA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome ------------------------------ End of LACTNET Digest - 27 Mar 2018 to 28 Mar 2018 (#2018-84) ************************************************************* *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome