>>5.  Pre and post-milking teat dipping helps prevent colonization and
>spread
>>of pathogenic bacteria. (Maybe we need to think about this when women
>are
>>pumping.)
>
>At UWisconsin, in the Dairy State, I think this dip is Iodine.

I wouldn't want us to return to the "germ-y" nipple/breast mind-set.  When
my first baby was born 30 years ago, I had to wash my nipples with an
iodine solution before feeding because I wasn't sterile.  It was really
rough on the nipples.

We now know about the anti-bacterial properties around the nipples, that go
on to reduce the bacteria count in the pumped breastmilk. If we encourage
moms to do anything before pumping, we could tell them to do a "breastmilk
wash" first.

One thing that I learned from Lactnetters within the past 2 years is that
not all "mastitis" is bacterially induced, or infectious.  Because of the
experience of many Lactnetters (search Mastitis in the Archives), I have
been recommending Ibuprofen--400mg every 4 hours--, cabbage leaves, plenty
of fluids and rest for 24 hours, and sometimes echinacea.  If symptoms
aren't gone, then Mom can call OB for antibiotics.  I have had only one
client out of dozens who didn't feel 75% better within 12 hours, with
healing continuing over the next 4-6 hours. This one client got her abx and
went on to healing without complications.

Some cases of mastitis are inflammation instead of infection.  The reason
that abx helps is its apparent anti-inflamatory effect. I am eager to do
what I can to reduce unnecessary abx use. But I am cautious about catching
infectious mastitis.

Among the criteria I use is evaluation the nipple integrity.  If nipples
are damaged, I suspect bacterial infection more readily. If it is a sudden
onset of tenderness, fever, redness, etc and there is no damage to nipples,
I feel confident in trying the anti-inflamatory, cabbage,etc route first.

I do encourage all of you who are new to Lactnet to do the mastitis search.
 There were some outstanding posts from very experienced LCs and MDs.

Patricia Gima, IBCLC
Milwaukee, Wisconsin, upper midwest USA


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