Perhaps I'm not understanding this thread correctly (I haven't read every post in the thread - sorry), but I've always thought of mastitis as an actual infection that requires more than the typical engorgement-type remedies. In other words: in addition to nursing often, rest (as if she wants to do much of anything when she has a fever!), and heat (yes, I suggest heat prior to nursings) - they need a *doctor* IMO, and probably a course of antibiotics. In my experience recurring mastitis is often mastitis that hasn't ever yet been treated with antibiotics. And not just for 2 or 3 days; some clients don't finish the bottle. If she has a fever and has lots of bodily aches/pains (i.e., symptoms not confined merely to the breasts - that's mastitis) then she needs a doctor, IMO, along with whatever tips I can give her about the breastfeeding situation specifically. My bottom line? Fever, feeling like you've been hit by a Mack truck. Those symptoms send you to a doctor ASAP, if you're a client of mine :-)...... Regina Roig Lane, BS, IBCLC for Miami-Dade County WIC -----Original Message----- Our treatment usually has cabbage leaves and ice, along with the attachment correction and removal of milk with baby or pump. We don't use warmth hardly at all anymore. If it is used it is only for a short time, immediately prior to a pumping/feeding, not for long periods. However, most all the literature list it as a first step. How many of you use it first? We find the ice/cabbage leaves tx reduces the edema and inflammation so much quicker to help with the milk removal. Soooo, what is everyone else doing? If ice/cabbage tx works best, how much longer until it gets into the books so others can use it as reference? Thanks, Evonne Davison RN, IBCLC > *********************************************** 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