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Subject:
From:
Nikki Lee <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 24 Nov 2003 12:31:07 EST
Content-Type:
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Dear Friends:
    The mother that called me for the deep breast pain (after the bleb,
antibiotic treatment, thrush and thrush treatment) was prescribed antibiotics when
she called her doctor complaining of the initial bleb. She had no symptoms of
mastitis. Her physician never saw her.
    The mother with the ENORMOUS abscess (over 500 cc drained by needle
aspiration) had received three rounds of different antibiotics from her midwife
before I saw her. Her midwives never saw her.
    My point is that practitioners (midwives as well as physicians) are quick
to prescribe antibiotics if the nursing mother complains about her breast at
all. This is a set-up for trouble in two ways. For one, it misses the real
diagnosis; and two, it is a set-up for yeast and for premature weaning when a
mother just gets tired of the pain and the drugs and the misery.
    There is no substitute for a face-to-face (or at least face-to-breast :-)
visit when a mother is having breast pain. Half of all mastitis is
non-infectious anyway, and can be resolved by the wonderful old-fashioned mantra: 'heat,
rest, empty breast'. Fatigue has been identified as a risk factor for
mastitis; so has oversupply. If positioning is poor and the nipple skin integrity is
broken, that must be fixed. None of these conditions lend themselves easily to
a quick telephone chat.
    Giving an antibiotic may seem like a quick fix to a busy practitioner. It
is a disservice (can one even say 'negligent practice') to the mothers and
babies.
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CIMI, CCE, craniosacral therapy
Adjunct faculty, Union Institute and University, Maternal and Child Health:
Lactation Consulting
Supporting the WHO Code and the Mother Friendly Childbirth Initiative

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