Someone asked about the systemic symptoms associated with mastitis - how they can come on so quickly. I explain to people that the symptoms of lethargy, aching, headache and even fever are caused by "milk fever". Milk that is banking up in the breast leaks out into the bloodstream and this leads to an inflamatory reaction around the body. Many years ago, Mavis Gunther, recognised the similarity of the fever of mastitis to the effects of an incompatible blood transfusion (Acute mastitis, The Lancet, Jan 28, 1956, 175-180). Maureen Minchin (Breastfeeding Matters) stresses that mastitis is not necessarily a bacterial infection: it means an inflamation of the breast. We still don't have an easy way of determining when a bacterial infection is present and antibiotics are needed. BTW I was talking to a homepath today and she casually mentioned that the homeopathic remedy for mastitis may vary according to which breast is involved. I was amazed! I don't understand homeopathy, but I would like to know if any studies have "proved" its effectiveness in mastitis. I see many patients who would rather not take antibiotics, and I find the idea of homeopathy intriguing. Also, thanks for the comments about "milk blister" - another area that needs more research! Lisa Amir GP / LC in Melbourne, Australia