>baby is 6 weeks old and mom is reporting she has her 5th breast infection.
tell me this isn't possible and we are talking misuse of language.  breast
infection really means plugged duct.<

OK Monique, we are talking misuse of language.

So often 'mastitis' is just assumed to be an infection but there has really
been no work to establish what proportion of mastitis is infectious and what
proportion is 'obstructive' (this terminology is used by Renfrew, Woolridge
and Ross McGill in Enabling Women to Breastfeed (2000) The Stationary
Office, London).  I think there is a debate to be had whether the
terminology 'plugged duct' or 'blocked duct' is not also misleading.  I
think plugs/blocks are one way that obstructive mastitis presents, but not
the only way.  (I recently realised that I stopped talking about them about
10 years ago).

Renfrew et al have this list:

 Some areas for further research

* There is a need to determine both the incidence of mastitis in this
country (UK) and its prevalence at different stages of lactation.

* Development of a simple differential diagnostic test to discriminate
‘infective’ mastitis from obstructive (‘non-infective’) mastitis in routine
clinical practice.

* Would the routine use of leucocyte and bacterial counts for women with
mastitis be cost-effective as part of a treatment protocol?

* Are there other factors which cause mastitis – e.g. illness, stress,
exhaustion and blocked ducts are associated with its occurrence.

* Nipple trauma is a possible predisposing factor.  What are the mechanisms
which might cause this and could this be prevented?

Reading their review of the literature (which is what 'Enabling' was
commissioned to be by the UK Dept of Health) combined with the WHO
publication on Mastitis (also 2000) shows us just how little studied
mastitis really is and how wide ranging and diverse the understandings and
treatments of it are in practice.

Magda Sachs
Breastfeeding Supporter]
BfN

btw, I disclaim all pretense of being any kind of expert on mastitis -- I
just know that from a solid look at the literature and careful thought about
what I have learned from women over the years that these conditions are not
as 'cut and dried' (if you'll pardon the image) as they are usually
presented in the literature.

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