Hi Sharon
I do not find expressing works for these women. Can I suggest that she
has a diagnostic ultrasound to see the trigger/cause? 
Plus when did the mastitis develop?
 I have seen instances of a "caked" breast in a women who are
suppressing, where there is residual milk that is gradually reabsorbed
over a period of time. There is no infection simply a wedge of solid
tissue. This is usually in women who started breastfeeding and weaned
abruptly and very early in their lactation. 

Gwen

Gwen Moody
CNC Postnatal Care
Westmead Hospital
PO Box 533 Wentworthville 2145
Phone: 02 9845 6964, 0422212774
Fax: 02 9845 8340
Page: 02 9845 5555 - 01135
email: [log in to unmask]

>>> [log in to unmask] 04/03/2009 8:56 am >>>
Wise friends and colleagues.  I need your help.  I have received a
consult
request from one of the clinics here on the reservation, but I really
think
this is outside my knowledge and scope of practice and wonder what you
think.
A nonlactating woman 1 month postpartum has mastitis in one breast. 
One of
the modes of treatment they have decided to use is to give her a pump. 
I
am assuming it is a hand pump.  She has no desire to breastfeed.  They
want
me to see her and make certain she is using the pump correctly.
We do loan electric pumps and provide hand pumps, so I am familiar
with
that as part of my scope of practice.  I am not at all certain whether
pumping is an appropriate method of treatment for mastitis since I've
always worked with breastfeeding women.  Perhaps some or at least one
of
you will have some ideas for me.  I will go to the town where the woman
is
(about 60 miles from here) tomorrow anyhow, so I guess I could see her,
but
I feel a bit uncertain about it.  I want to tell her to nurse
frequently,
but then again, that is not her desire.
Hoping for your ideas.
Sharon Jimenez, RN, IBCLC
Apache Diabetes Wellness Center
White Mountain Apache Tribe

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