Regarding Victoria Nichols-Johnson's post - I posted this to Lactnet
several months ago.  Sorry for the repeat but I didn't have a date to
direct to the archives.  I wonder if the use of IV antibiotics would have
altered the cause and eliminated progression to mastitis.  I also wonder if
it would have been appropriate to C&S the milk with the onset of
post-partum mastitis.

Trudi Szallasi's post reminded me of a study I would love to do or see done
- mastitis during pregnancy leading to abscess in the early post-partum
weeks.  I have seen three cases clinically where the mother had mastitic
symptoms during pregnancy subsequently treated with (oral) antibiotics.
Babies' breastfeeding behavior were all within normal limits, transferring
and draining the breasts appropriately.  Mastitis reoccurred during the
early post-partum weeks and was treated correctly yet progressed to
abscess.  Two of the mothers were primpis and the third was a multip.  It
don't know about lump mobility because I didn't palpate during pregnancy.
(Didn't even meet the mothers antepartumly.) Post-partum they were tender
and other symptoms were typical.  I wonder if there is a possibility for a
kink or some other anomaly to occur during the proliferation of the alveoli
and ductile groundwork.  This kink is a catch for bacteria to multiply and
milk to stagnate.  There are more questions than answers for so many of
these situations.  However this seems like a possible answer.  Any
comments?

P.S. One of the mothers consulted with me with her next baby.  No
antepartum mastitis occurred nor did any postpartum mastitis.  This mother
had her abscess needle aspirated several times and the lanced.

Joanne Burke Snyder, MA, CLE, IBCLC ([log in to unmask])
Latch-On Services,  A Private Practice in Indianola, Iowa