>Personal experience only here, repeated bouts of mastitis, plugged ducts
>with 4th baby.  Yes, I would notice a supply decrease.  I figured it was
>brain telling breast, slow down, something is going on down there. The flip
>side is decreased supply led to more frequent nursing by baby boy and
>supply
>usually picked back up to normal by time breast felt better.  After the
>first bout or 2 I didn't use antibiotics.  Just heat, rest and frequent
>emptying - straight from WABF in 1966. :-)

>Now I can't quote you on anyone else's experiences. Not sure if there is
any
>research on topic either.  Pat in SNJ

I have published a couple of papers relevant to your question, from research
I have done in this area:

Fetherston, C.M. Lai, C.T. & Hartmann, P.E. 2006. Relationships between
symptoms and changes in breast physiology during lactation mastitis.
*Breastfeeding
Medicine* 1(3) 136-145.**

Fetherston, C.M. Lai, C.T. Mitoulas, L.R. & Hartmann, P.E. 2006. Excretion
of Lactose in Urine as a Measure of Increased Permeability of the Lactating
Breast During Inflammation. *Acta Obstetrica Gynaecol*  85:2025.

am happy to forward them if you need them but a quick summary is:

The reduction in supply following inflammation appears to be related to two
main mechanisms, one is destruction of lactocytes resulting from the
inflammation and infection and the other is a change in paracellular pathway
permeability and loss of lactose and subsequently fluid from the milk space
into the interstitium. Loss of supply is generally related to the severity
and extent of the infection or inflammation.

Best bet in preventing this problem is to prevent the mastitis occuring in
the first place, particularly avoiding nipple trauma and ensuring good milk
removal, if mastitis does occur, its very important to make sure it is
treated promptly and milk is removed often and frequently to enhance
function of the remaining unaffected lactocytes.

regards

Cathy Fetherston

IBCLC PhD

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