Dear Brenda and Zena,

Having just done a series of workshops on the topic of oversupply, I thought that I would jump in here.
1.  Treat the cracked nipples with antibiotic cream and gently clean them a couple of times a day with soap and water.
2.  If possible, do a culture and sensitivity on the milk;  in general, keflex and dicloxacillin seem to be the most commonly used and usually effective antibiotics; continuous low-dose antibiotics have been effective in stubborn cases of repeated mastitis,
3.  To get oversupply under control:  First have mom totally pump out both breasts with a good pump, hospital grade if possible.  Then begin one-sided nursing, starting with 2-3 feedings (or 4-6 hrs.) on one side, then switching to the same pattern on the other side.  Pump or hand-express on the unused side only if beginning to show signs of engorgement such as lumps or hardening.  Yes, she will need to be on the lookout for mastitis.  It may be better to work on oversupply with these moms when they are already on antibiotics.
4.  It is possible to have mastitis and/or abcesses without fever.

There is a ton of stuff on mastitis in the archives, including non-antibiotic treatments.  Take a look.  This has been heavily discussed on Lactnet over the years.


Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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