Hello All,
I have done several searches of the L-net archives, and gotten more posts
than I can read on mastitis in general but very little that address my
current concern.  That is, several texts and Jack's handout mention that
many cases of mastitis are inflammatory and will resolve after 12-24 hours
of the usual self-care measures (moist heat, massage, frequent feeds,
increased fluids, and rest).  If the woman with mastitis also takes an
NSAID, and her symptoms are relieved, how do you decide whether her mastitis
is resolving because it is inflammatory in nature (VS infectious), OR
whether she's just getting symptomatic relief from the Ibuprofen, and should
possibly start on antibiotics? Will she still be running a fever and have
flu-like malaise on top of the NSAID?  Is there a temperature that has been
established as the criterion for starting antibiotics?
  I thought I had this one in hand, and then one of our relief nurses
covered call, treated a case of mastitis a bit differently than we usually
do and had a lot of good questions, which left me stumped.(we generally give
the mom the option of starting abx right away or treating at home with the
usual measures + NSAID of her choice, and THEN starting abx if she isn't
getting better after 12-24 hours.)
  Please respond to me privately, references wd be most appreciated.
Thanks In Advance From:
Martha Johnson RN IBCLC
Eugene, Oregon

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