So Theresa, I have no idea how common this might be. As for culturing, I
think it would be very difficult. The best course of action may be a course
of antibiotics and see what happens. if the pain goes away, then a
bacterial infection may have been the issue. I would point out that many
antibiotics also have an anti-inflammatory affect so may provide some
relief even before any bacterial infection is knocked down. There is also
the possibility of treating with probiotics in order to reestablish a
healthy microbiome in the breast, although not sure what kind of probiotics
one would use - the more we study probiotics, the more we realize that we
don't totally understand how they work or even if they help at all in most
situations. There is also the possibility that the mother has developed a
pain syndrome that remains even after the infection is gone - sometimes
pain pathways remain stimulated even when it seems like they should have
calmed down.
Sharon
On Wed, Jul 17, 2019 at 8:48 PM Theresa Moutafis <[log in to unmask]>
wrote:
> This is fantastic info. Thank you Sharon. How common are these scenarios in
> your opinion? Is there a way to test for this breast bacteria if not
> present in the milk?
>
> On Wed, Jul 17, 2019 at 12:34 AM Sharon Knorr <
> [log in to unmask]> wrote:
>
> > It can be difficult to determine the source of an infection, especially
> if
> > a biofilm is involved. If the organism is not being actively shed into
> the
> > milk, but is instead mostly adhered to the ductal tiissue, then it may
> not
> > show up in a standard milk culture or perhaps in very small numbers that
> > may not signal an infection to a physician. We now know that human milk
> is
> > not normally devoid of all microorganisms, but develops its own
> microbiome.
> > Just as in other parts of the body, that microbiome may be very healthy
> or
> > it may be skewed more towards less beneficial or even pathogenic species.
> >
> > Sharon Knorr, BSMT(ASCP), BfUSA counselor
> > Colorado, USA
> >
> > On Wed, Jun 19, 2019 at 6:16 AM Theresa Moutafis <[log in to unmask]>
> > wrote:
> >
> > > Fantastic Pat - she mentioned getting tested for bacterial infections
> as
> > > well (which were all negative), but it's not clear what exactly was
> > tested
> > > for. I'll put this on my growing list of to-dos! Thank you!
> > >
> > > On Wed, Jun 12, 2019 at 11:05 AM Patricia Young <
> > > [log in to unmask]> wrote:
> > >
> > > > The description seems to reflect dysbiosis/subclinical mastitis
> > > >
> > > > A Lactnet quote from Marsha Walker Mar 26, 2018 said "Burning breast
> > pain
> > > > is often indicative of subacute mastitis, not yeast. The bacteria
> > > > responsible for subacute mastitis can form thick biofilms impeding
> the
> > > flow
> > > > of milk through narrowed ducts, contributing to the inflammation that
> > is
> > > > responsible for needle-like pain. This is a dysbiosis model of
> > mastitis
> > > > which is being treated with specif strains of probiotics rather than
> > > > antibiotics in a number of research papers.
> > > > Marsha also wrote an article for Clinical Lactation 9(3) 130-136,
> 2018,
> > > > Mammary Dysbiosis: An Unwelcome Visitor During Lactation.
> > > > I think I remember reading that abx treatment needs to be longer than
> > the
> > > > usual 10 days.... not sure where-sorry.
> > > >
> > > > the white coating on the infant's tongue may reflect reflux.....
> > > > another article "Role of oral antibiotics in treatment of
> breastfeeding
> > > > women with chronic breast pain who fail conservative therapy."
> > > > Breastfeeding Medicine 9(2) 63-72. 2014. Ann Witt et al.
> > > >
> > > > Pat in SNJ
> > > >
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> > > --
> > > Theresa M. Moutafis, MA, RD, LDN, CDE, IBCLC
> > > Nutrition and Wellness Consultant
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