Mastitis is not a contraindication to breastfeeding; in fact, it is important to continue to empty the breast on the usual schedule. Even when an abscess has to be surgically drained, breastfeeding should continue unless the incision for drainage is on the areola. An undiagnosed abscess that ruptures spontaneously into a duct would require interruption of breastfeeding on that breast, and the breast would require routine pumping on schedule to hasten the healing. Direct breastfeeding on that breast should resume as soon as drainage stops and antibiotic therapy has been in place at least 24 hours. Most common causes are staphylococcus and E. coli. If streptococcus is suspected by culture or because mastitis is bilateral, the infant should also be treated vigorously. The diagnosis is made when a tender, warm, red swollen area appears on the breast, usually in a wedge shape, and the mother has a temperature and flu-like symptoms. In contrast, plugged ducts arc not red and warm, and the mother is well. Plugged ducts can be relieved with warm compresses and massage to remove the plug. Continued breastfeeding to help this is very important.
Recommendation. When mastitis is suspected, the mother should be seen immediately, the diagnosis confirmed, and antibiotics initiated, Antibiotic treatment must be maintained for 2 full weeks to avoid relapse. Relapsing mastitis is extremely difficult to clear. It is easier to prevent it than to cure it. Continued breastfeeding is essential (antibiotics are discussed in Chapter 4.4).
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For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.