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Date: | Wed, 27 Jun 2012 20:38:09 +0100 |
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Dear wise ones
I am supporting a mother by email since last Wednesday, and have
permission to post. Her baby is 10 weeks. The mom has been
suffering severe bilateral nipple and breast pain for 6 weeks and was
treating for Thrush, including a 10 day course of Fluconazole. The
pain persisted in spite of the Fluconazole which is when she contacted me.
I described nipple/breast? thrush and suggested that if the pain
hadn't resolved in all this time, then she should contact her doctor
and request a nipple swab and milk culture. She did. Last Friday
the milk culture came back positive for S Aureus and the doctor
immediately prescribed flucloxacillin. Over the weekend the pain
lessened a bit and mother was feeling relieved. Today her doctor
contacted her again to let her know she has MRSA of the nipples. He
is prescribing topical mupirocin. The baby has been examined and is
asymptomatic. The doctor has contacted a microbiologist to confer,
but everyone seems uncertain about whether continuing to breastfeed
is safe for the baby. And the mother is about ready to wean, being
concerned for her baby and wondering whether continuing to breastfeed
is worth it. Her baby has been receiving 1-2 bottles/24 hours for
the last week or so.
A search of the Lactnet archives doesn't throw up a lot, but it seems
that continuing to breastfeed might be safer for the baby than
weaning at this point. And for the mother, in order to avoid
continued/worsening of the breast infection and possible abscess. In
your opinions, is this correct?
If the mother stops breastfeeding, she wonders if it is safe for the
baby to have her expressed milk? I wonder whether it would be safer
for her to pasteurize it (to inactivate any infectious organisms) or
whether it would be safer for the baby to have the full complement of
antibiodies to the MRSA that she is surely producing after all these weeks??
Any help and information would be very, very gratefully received,
including usual antibiotics for MRSA (is flucloxacillin sufficient to
treat this?) Thanks so much!
Pamela Morrison IBCLC
Rustington, England
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