Hi Everyone
I am hoping that someone on Lactnet may be able to help me
with this case.
I saw this mother a week ago. She presented with a mastitis
in her L breast from 3-9 o'clock inclusive.It was extremely
red and painful but she had no lumps. She also had signs of
thrush(razor like stabbing pains in her breast, burning
nipples.)There were no other  visual signs. She had finished
a 3 1/2 week course of Flucloxacillin(500mg 8 hourly
orally)for the mastitis, (with only a slight change in the
redness of her breast) 5 days before I saw her. She was told
to stop the antibiotics as she 'had been on them long
enough'.
I recommended to her Dr that she be admitted to hospital for
IV antibiotics and that she start Diflucan as well as
topical antifungal cream and oral treatment for the baby.The
mother was admitted to hospital several hours later and
commenced on the above treatment but was discharged 48 hours
later on oral antibiotics for the next 4 days.There was only
a slight  change in redness to the L breast.
After 1 week  of Diflucan, topical and oral treatments and
the antibiotics the pain has not improved and is
excruciating. She has been back to the Dr and the antibiotic
has now been changed to Erythromycin with little effect as
yet(36 hours later).She has also consulted a homoeopath who
prescribed homeopathic Staphlococcus and Streptococcus to
take while she was taking antibiotics.
Mum is pumping or hand expressing off the affected side and
using this EBM to top up breastfeeding from the R breast.Her
7 week old baby girl is contented most of the time and
gaining well.
She has been using ice prior to expressing on the L breast
and she finds this helps with milk flow.She is breastfeeding
and expressing about every 3 hours.
Has anyone any further suggestions as to how this mother can
be helped and why this mastitis has not improved?
I look forward to your replies.
Regards
Barbara Fletcher
RGON IBCLC
New Zealand

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