Recurrent mastitis can be so discouraging to both the mother and those of us
working with her. During the literature research that I did when writing the
new LC Unit on mastitis for LLLI, I was amazed and disappointed in the lack
of good research on mastitis. Mastitis is a term used for both an
inflammation and an infection - two different entities. The mother described
with the recurrent mastitis may indeed have the infection (high fever) but
may be treated with the wrong antibiotic. Milk samples can be looked at under
a microscope for leukocyte counts and bacteria colony counts, however
pathogenic bacteria may not be cultured. Antibiotics are also good
antiinflammatories which is why women feel better after being started on them.

Was the baby cultured as well as the rest of the family? Mastitis the
infection frequently recurrs when the bacteria is resistant or not sensitive
to the prescribed antibiotic. Was a sensitivity test done on the culture to
see if any bacteria was sensitive? Was group B beta-hemolytic strep looked
for?

Marsha Walker, RN, IBCLC
Weston, MA

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