>OK, I'm now going to stick my proverbial neck out and suggest that bacteria
>are not actually involved in mastitis (maybe some, but not as many as is
>usually assumed). Shock! Horror!

>I hypothesise that damaged nipples have a positive association with
>mastitis because poor attachment and poor drainage actually contribute to
>both of these  (as Ros alluded to above). I furthermore hypothesise that
>the inflammation associated with mastitis is just that, and not infective.
>Inflammation can be caused by the milk being forced out of the ducts and
>into the surrounding tissue (which was also mentioned in Ros's post I
>think). The reason antibiotics 'work' is that they have an
>anti-inflammatory effect.

Hey! I love this!  I remember from long ago reading that breast "infections"
aren't really infections but tissue inflamation.  I've explained this to
moms when they are concerned that their milk is "infected."

I am most concerned about the  excessive use of antibiotics and if they
"work because they have an anti-inflamatory effect" then why don't we use an
anti-inflamatory instead of antibiotics?

I presented the question in summer of '96 because I had a mom with severely
damaged nipples who took a break from breastfeeding and was pumping.  She
didn't want to use anti-biotics with her br. infection that followed the
sore nipples.  Her infection went on to become an abscess (the first I had
been involved with) and someone proposed that the abscess was caused by
enclosed bacteria and would have needed the antibiotic because of the source
of the "infection."

Let's hear it from all of you, even if it's not researched, but *just* your
opinion based on years of experience and your own inner wisdom. The current
treatment of mastitis is serious with the accompanying yeast overgrowth as
well as adding to the resistant strains of bacteria.

Sorry if this is unstructured and sketchy.  I'm off to an early meeting, but
I wanted to get this thrown into the thread.

Patricia Gima, IBCLC
Milwaukee
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