Repeated mastitis is a cause for concern. Six cases warrants a closer look at
a number of issues. First, has a culture and sensitivity test been done on
the milk. In my experience, many times the mother is given the wrong drug for
the wrong bug. The next time she show signs of impending mastitis recommend
that her milk be cultured. A sensitivity test will determine which antibiotic
the bug is sensitive to. Many bacteria are resistant to antibiotics.

I have also had at times recommended that the baby, father, and other members
of the household be cultured as carriers of bacteria that are invloved with
the mother's mastitis. Sometimes the whole family needs to be treated. One
family I worked with had a father who was a dermatologist and was bringing
home the resistant bacteria!

Low dose antibiotics over a long period of time has also been shown in some
instances to be effective at keeping the bacteria at bay.

Marsha Walker, RN, IBCLC
Weston, MA

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