Hello, All.
    I need your ideas.  I just started working with a mom whose baby is 6 weeks old and unable to latch well.  She has been mostly pumping for one month.  She puts baby to breast once every other day, to clear out plugged ducts.  Even though he only nurses for a few minutes and hurts her quite a bit while at breast, he still clears out the plugs better than the pump she was using (8-year-old pump, brand I never heard of).  If she doesn't clear the plugs, she gets mastitis.  She had mastitis (fever 101 degrees) last week.  But this problem has been there since she started pumping.  (I have since gotten her to rent a Symphony, and we talked today about starting lecithin, which will hopefully help reduce the number of plugged ducts.)
    *Every* time she pumps, not just after a bout of mastitis, she get long strings of gel-like milk from the left breast (not the right one).  They actually collect at the bottom of the nipple tunnel of the pump's breast flange.  Now, I've seen stringy, clumpy milk come out when we clear a plug.  But she has this even when she has no palpable plug.  I am mystified.  It started before she ever had a bout of mastitis, so I'm thinking (perhaps incorrectly) that it's not related to infection.  Could she have a continous low-grade infection of some sort?  Should I suggest she ask her doctor to culture one of these strings?  I'd appreciate your ideas on this situation.
   Dee Kassing, IBCLC, RLC
   Collinsville Illinois in central USA

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