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Date: | Thu, 17 Dec 2015 09:38:33 +0000 |
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Oh Kika, that's absolutely shocking! I would put
the "findings" down to persistence of really
outdated policies and practice that didn't value
breastfeeding. I'd love to know how long the
mothers and babies were followed up, how on-going
lactation/breastfeeding went, if it was
successful (if the baby thrived without supplements) etc etc.
I believe that mastitis is just about preventable
if everyone jumps around from Day 4 - 9 to ensure
that the breasts are extremely well drained
(preferably by baby, but if not, then manual
expression or a pump) .... but if it occurs, then
what seems to work best is super-drainage and Abx
after 24 hours if there is no resolution of symptoms.
Whenever I've worked with a mother with an
abscess there's _always_ a history of persistent
engorgement/induration which was just left.
I do think that cabbage leaves on engorged
breasts seems to work to calm down over-supply a
bit - accompanied by expressing/pumping/lots of
breastfeeding - but really, progesterone
gel?? I'm sure it would work, but do you really
want to suppress lactation, or just to manage it?
Why do we mess with a mother's hormones so much
without a thought? I have a little case history
of one which was published in the Central African
J of Med where estrogen patches were used to
treat postpartum depression and definitely worked
(baby didn't gain and newborn jaundice just went
on and on). Bromocriptine depresses prolactin
levels thus suppressing lactation, but has other
horrible side effects - severe risk of depression
and I've had mothers describe how they had to
crawl to the loo, rather than walking because
they were so dizzy. And besides which
bromocriptine has been contraindicated for new
mothers for about 20 years now due to the risk of death or stroke!
I'll be interested in others' comments.
Pamela Morrison IBCLC
Rustington, England
--------------------------------------------------
Date: Wed, 16 Dec 2015 17:00:21 +0100
From: Kika Baeza <[log in to unmask]>
Subject: Suppression of breastfeeding to treat mastitis?
Hi everyone,
I´ve just come across the abstract of this article, and I must say I am a
bit shocked at the conclusions.
My librarian has not been able to access the article. Has anyone read it?
J Matern Fetal Neonatal Med. <http://www.ncbi.nlm.nih.gov/pubmed/26513602#>
2015 Nov 30:1-5. [Epub ahead of print]
Management of mastitis and breast engorgement in breastfeeding women.
Pustotina O
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Pustotina%20O%5BAuthor%5D&cauthor=true&cauthor_uid=26513602>
1.
Author information <http://www.ncbi.nlm.nih.gov/pubmed/26513602#>
Abstract
OBJECTIVE:
To identify the best management approaches to mastitis management in
breastfeeding women and heavy breast engorgement in the early postnatal
period.
METHODS:
We compared various international guidelines and reviews on mastitis
management in breastfeeding women and breast engorgement treatment.
RESULTS:
Effective milk removal is recommended as a first step in mastitis
management. Active emptying of the breasts can prevent mastitis development
in most cases. If it fails, antibiotics should be administered for 10-14
days with continuing breastfeeding. Russian guidelines recommend antibiotic
therapy during 5-7 days with temporary bromocriptine-induced breastfeeding
suppression. In case of heavy breast engorgement after lactation is
initiated, Progesterone-containing gel can be administered. Application of
the progesterone-containing gel on the breast skin improves swelling, and
reduces engorgement and tenderness in 15-20 minutes.
CONCLUSIONS:
Antibiotics with temporary suppression of breastfeeding are more effective
than with continuing breastfeeding in mastitis management. The
progesterone-containing gel is recommended on the 3rd-4th days after
childbirth in heavy breast engorgement to prevent mastitis.
--
Dra. Carmela Baeza
Médico de Familia
Consultora Certificada en Lactancia Materna IBCLC
www.centroraices.com
http://www.facebook.com/Consulta.Lactancia.Raices
<http://www.facebook.com/pages/Centro-de-Atenci%C3%B3n-a-la-Familia-Ra%C3%ADces/274415189309122>
Autora de "Amar con los Brazos Abiertos"
http://www.ediciones-encuentro.es/libro/amar-con-los-brazos-abiertos.html
Comprometida con el Derecho a Vivir
http://derechoavivir.org
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