Chris,
Re the mother with mastitis who is not responding to antibiotics, I would
recommend a clean catch culture of milk from the affected breast.  We have
done this when mothers are not responding to the typical antibiotic therapy
and have found some different than the usual bugs.  I swab the nipple with
betadine, wait for it to dry, rinse with sterile water, wear a sterile glove,
hand express until I get a stream of milk (discarding the first tsp to tbsp)
and then collect 10 ml or so in a sterile plastic urine specimen container.
We label it as breast milk, right or left breast, and send it for culture and
sensitivity. ..then, hopefully mom can get on the right antibiotic. Also,
with her past history, I would think it might be a good idea to have her on
IV antibiotics in the hosp.
Good luck.

Kathy Boggs, RN, IBCLC

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