anyone have experience with breast abcess

[davi]

this might run a little long, so i'll apologize in advance, but i am really in need of some help. my dd is 5 months old & when i was 36 weeks pregnant, a lump was found in my breast. did a biopsy & it showed "inconclusive" results. so, i was transferred to a "breast clinic" for further evaluation. they decided after an ultrasound & 3 more biopsy's it was a plugged duct. well, after i had dd & my milk started coming in, it turned into a raging abcess. so, they decided to open it up & drain it DURING which, i am told by the surgeon "well, we dont have much experience with lactating breasts here"...ummmm what? a breast clinic that isnt familiar with a lactating breast? i actually had to give this doc a copy of "Medications & mother's milk" courtesy of my LLL leader as they were telling me over & over to stop breastfeeding so they could treat the infection more aggresively& had no resources other than a PDR. so, i have been only nursing from the one side all this time & have let the infected breast "dry up", but the abcess seems to be coming & going still 5 months after the fact. the incision site will heal up a bit & then re-open of it's own accord. the dr's office has no explanation for why & the most recent test they did on fluid draining from the incision came back as bresat milk. i was wondering if anyone has been through anything similar? if so, how did it resolve ? thanks for any input!

[emilysmama]

I had an abcess drained when my dd was 6 months old.

My experience was not as bad as yours, but there are a couple similarities. I didn't have a lump before birth. When dd was 3 months of old, I developed a plugged duct, which became infected. I went to see many people who should have been qualified, but they insisted that nothing was wrong. Even though I had almost all of the symptoms of mastitis, I was told that there was nothing wrong with me because I didn't have the classic red marks of mastitis. I was given some antibiotics, but they didn't help.

Finally, after fighting with this with months, someone had the sense to send me to my general surgeon, who is a woman. (Later after the dust settled, my dad told me that a lot of women who are general surgeons tend to specialize in breast issues.) This particular surgeon was breastfed all of her children to 14 months herself. I finally saw her when my daughter was 6 months old.

Anyway, the important fact of the matter is that she found an abcess, and drained it on the spot. She said it would be fine to breastfeed on that breast, and I had no problem with the incision. (That's why I am puzzled why you were told not to breastfeed on the infected side. Perhaps there were issues other than the incision?) Incision healed beautifully without ever opening up or infecting, even while breastfeeding. After three months of trying to figure out what was going on, I figured that the infected breast was all dried up, and the surgeon herself could not really say. After she did the procedure, and I asked her if the milk would come back in that breast, she told me to prepare myself for the possibility that that side would be done. And yet, it wasn't. I breastfed that side starting right after the drainage (as the surgeon instructed), and kept going, and that breast came back with milk as strong as ever within a few weeks. So maybe your breast is still lactating and not really dried up.

The other question I have is probably really stupid. Did the surgeon pack the inside of the incision with gauze? I think he/she should have. At least my surgeon did with mine. The wound has to heal from the inside out. It's not like you can just put stitches on top of it and expect it to close. I'm almost embarrased to ask this question, because it seems like a really basic thing. However, my dad, who was a general surgeon scoffed at the packing job that my ob-gyn did when the ob-gyn had to drain an infection on my c-section wound.

Can you get a second opinion? Preferably from a general surgeon who is a woman? One who has breastfed if you can find one? Even if not, I'd want a second opinion from another surgeon.

[davi]

thanks for responding. yes, they did pack it, but i am sure it wasn't done well as there is what feels like a "sink-hole" in the skin right next to the incision. i was actually going to a wound clinic & having it re-packed every other day (that was horrible) shockingly enough, this WAS a female surgeon who specializes in breasts & she breastfed her own children. i thought i would be in capable hands, but am now re-thinking that decision. the reason they had me stop nursing is because my incision was in my areola just a few centimeters from the nipple. i did try and pump a couple times recently & got a very very thick milk out of that breast, but it was coming out in a slow drip & looked like Elmer's glue (does that make sense?) i am thinking that you are right & the breast is still lactating & am wondering if perhaps the original plugged duct is still in fact plugged. i didnt think a breast that was engorged & "ready for action" & never used would be functional without having to go through the process of relactating it. thanks for responding though, i am at such a loss as to what to do next & it just feels like a never-ending problem at this point.

[MamabearTo4]

I've recently gone through surgery, too, to drain two golfball-sized abscesses in my tiny R breast. Mine was done by a general surgeon, and I'm very happy with the healing. I had a 1 1/2 - 2 in. incision around my areola that was sutured closed, with two drainage tubes connected to collection bulbs that I had to monitor. I had been on Dicloxacillin for 12 days when the pathology report came back as strep pneumonia bacteria in the fluid he collected...then I was on Keflex for another 10 days because I didn't have the right abx to kill the bacteria in the first place! :

The day that my sutures were removed, he noticed a hot spot on my breast and what looked to me like a tiny infection at the suture site. He told me to watch it like a hawk and to apply heat to the incision. Later that night, what I thought was an infected suture hole became the escape route for pus, blood, and eventually milk! TMI? Once the drainage was coming out of the incision site, it stopped going through the tube, so that was finally removed.

My surgery was on Jan. 2, and the site closed fully about 4 days ago. At the end, only milk was coming out. I had planned to wean from the right side, but I tried pumping last night to see what I could get - looked alot like colostrum, but not even 1/8oz! Babe has been eating well from L breast and few solids alone, but right after the surgery I did have to get some milk from a friend to supplement.

I thought I would have to have my site packed like yours, but he did mine differently, for whatever reason. My breast was as hard as a rock after the surgery, but has softened up a bit.

How are you feeling now? Did they send the fluid away for pathology? Results?

My surgeon recommended heat on my breast, even right after the surgery, 4 times a day for 15-20 minutes. He said that the heat would bring any remaining infection to the surface, and THAT IT DID! But I was pleased that the junk was flowing out of my body instead of stagnating inside. Heat has never done me wrong... Maybe you could try that.

[vwh99]

Wow...we should keep in touch. Sounds like you just wrote my story.

My son is just turning 6 months. When I was 38 weeks, I had a fine needle biopsy of a lump that showed up my last trimester. FNA was negative, but that area turned a raging red two weeks after I delivered and I was put on antibiotics. Didn't get better and I was scheduled for another biopsy since they thought that maybe it really was cancer (WORST feeling in the world to think you have cancer when you have a newborn!!!), but it started to open up and it was obviously infected. So instead of a biopsy, I ended up with an I & D.
After that first I & D, I also had 'sinkholes' which were sore/red. Surgeons kept saying that it was fine, but after month of not healing and a second drainage via aspiration, I had to beg them for a second surgical I & D. Turns out that the area was still majorly infected and they got a ton of pus out. My surgeon and I think that my infection was just 'honeycombed' inside and there were pockets of infection that continued to evolve after the first abscess was drained. Have 3 nice big scars to show for it.

Anyway, about a month ago, I noticed a 'mushy' sore spot-when I pressed, I got out bloody pus material from one of the incisions. Since then, that area healed up well and two of my incisions look great. Lately, my original incision is also opening up and leaking thin bloody liquid. This time I don't think it's infected since there's no pain, unlike the other times with the abscess opening up where there was a 'tearing' sensation of the skin. Just had an ultrasound of the area and the radiologist was able to see a tiny tunnel from the skin surface/incision down to tiny pockets of fluid. She wasn't able to say whether it was milk or pus, but everyone's guess is milk since I still have milk leaking from that nipple. Have you had another ultrasound of that area? Is it red or sore?

Anyway, I also ended up just letting my abscessed side 'dry up'. I was just too sick to keep up with the pumping after my second surgery and with 3 huge, gaping, leaking wounds, I didn't want my newborn 'clawing' at the area. My surgeon is still amazed that I kept up with the breastfeeding, but at least now she knows that it's possible to keep it up even with a nasty infection!! We think that the incision will still leak milk until I'm fully weaned, but I'm hoping this fistula will close so that no new infection develops.

Anyway, hope this isn't too long, but I feel that we're in the same boat and I can understand your frustration. Keep in touch and let me know how you're doing.

Val
Mama to a big boy (17 1/2 lbs at 4 months....and we'll find out how big he is next week!)

[davi]

after they drained the big abcess, the path report came back as a strep infection. i spent 3 months on keflex & augmentin altern&atively. i have been applying warm compresses & actually tried the pumping because i thought maybe helping the infection get out would speed the healing process a bit. but, like you said, i am still getting some milk out of there. but there is also the leakage from the incision site that concerns me. it varies in consistency & color (TMI?) sometimes it's green & thick, sometimes thin & clear & sometimes blood-tinged. the doc also gave me the "it could be cancer" spiel as well, which combined with post-partum hormones almost gave me a nervous breakdown. they shouldn't be able to say those things without definitive answers. my doc is also shocked that i have been able to continue breastfeeding, except for right after the surgery (had to give formula & had a major breakdown about that as well) as a result of this craziness, the one boob i feed from has had mastitis twice & thrush once. that was a whole different frustration though! you ladies have really given me some hope here, everyone i have spoken with locally hasnt heard of this happening with so many complications. i agree about keeping in touch also. thank you so much for sharing your experiences!!

[Fiercemama]

Just skimming over the posts. No quick answers. I am wondering if not nursing on the affected side, trying to let it dry up, is what is causing the healing tissue to keep breaking open and then leaking milk? When you keep the supply going there, it does heal more slowly, but the healing is usually better.

The "sink hole" sounds normal to me. The abscess creates a wall to localize the infection. It takes some time - a few months? - after the infection is resolved for this wall to break down and be absorbed.

It takes a really long time for your milk to be 100% dried up. My DD weaned months ago (after many happy years of nursing after the abscess I might add!) and if I try now to express a drop or two (sniff ) I get very thick yellowy milk.

IMHO, if you are concerned that there might still be an unresolved plug there that's still causing problems, nursing on that side might be just the ticket? I have heard tell of the use of ultrasound - like the kind you might have in physiotherapy, not diagnostic us - for helping to resolve persistent plugs, abscesses, etc. Work your local network of LC and/or LLL leaders to see if anyone knows anyone who specializes in this or does this kind of treatment.

Here's my story. My link is at the end if you (or anyone else) wants to get in touch. I'm not online over the weekend tho. http://www.kellymom.com/bf/concerns/...t-abscess.html

[davi]

rhondda, there were so many similarities in your story...my biggest hold up from pumping that side is that the incision is actually in my areola just centimeters from the nipple. the abcess was directly behind & just under my nipple, so they said that was the only place they could make the incision. the LC's in my area are not very knowledgable, but thankfully my LLL leaders have been amazingly supportive & helpful. but, like you said, this forutnately doesn't occur very often, so there isn't much out there in the way of research & info regarding it. i was honestly shocked at the number of times i have heard "well, you're just going to have to give up nursing" even from random people whose opinions i didn't ask for. nursing from one breast has definately been a challenge. at one point i was also told AFTER they gave some medication that i would have to pump & dump, so i did that & when you are working from only one breast, just a little time with a pump REALLY affects your supply. i just had a friend of mine tonight tell me "she's ready to start food now anyways, WHY are you still nursing her?" when i told her that i would be nursing until Lilly is at least 2 years old, she was appalled. (keep in mind, she said this as she was mixing a bottle of formula for HER 6 month old dd) but i would LOVE to have 2 working breasts at any point in the game here just for convenience sake. my supply is very tenuous after being on fenu-greek, blessed thistle, reglan, mother's milk tea oatmeal everything i can think of to bump it up, so Lilly nurses about every hour (thank God for slings!) you have some really great information as well. thank you so much for sharing your story. sorry for any spelling issues, i'm nursing her as i type...

[RachelGS]

Call the Academy of Breastfeeding Medicine and ask for a list of physician members in your state. Then start making calls. This has saved me from soooooo much trauma with doctors who don't know anything about the function of a breast.

[Fiercemama]

Great idea, Rachel! Wish I'd thought of this at the time!

Keep going, davi. If this hasn't stopped you, nothing will! You are one committed mama. Let me know if I can help you with anything else.

[davi]

commited like a mental patient! seriously, aside from the joy of the baby in your life, breastfeeding them is the best experience you can have...EVERYTHING about having children requires you to be constantly adapting your life, so i think of this as the beginning of many other challenges yet to come...but, you only get this one opportunity once in your child's life & i really believe that it is one of the most important things you can provide for them. but thank you ladies for the ideas & suggestions & support! i am thrilled to have found this board.

[clittle760]

Hey all,

My wife has just had a similar thing. She had a lump in her R breast that she discovered years ago, and went to the doc. The doctor reasuured her after some tests that it was NOT cancerous in the least.

Fast forward to the recent pregnancy, everything was going fine until her milk came in. Ethan (DS) showed a preference for the L breast, and refused to latch on to the R one, perhaps because of the location of the lump (right under the areola). Anyway, about 2 weeks ago, she noticed some redness and it was sore to the touch, so we figured that the lump had increased in size, and blocked a milk duct. We went to see her OB (the one who delivered our son) and she was put on Dicloxacillin for a 10 day course. She is just now finishing up that course of antibiotics.

In the meantime, it became more and more red and swollen to the point where if the R breast was even touched it caused extreme pain. So, we went back to the OB, and he referred my wife to a general surgeon. When we went in to see the general surgeon, he made a small incision right above the areola on the R breast to drain it. He said copious amounts of pus came out. We have been back to see him every day since then, and the pus has lessened over time, and according to him, she is now leaking milk out of the wound (which is packed with gauze btw).

Finally, the doc says she may have to stop breastfeeding, because as long as there is milk leaking into the cavity left by the lump that he removed, there is a good chance of a return episode of mastitis.

After all that, my question is...

Is it possible for her to dry up the milk supply in one breast, or will she have to stop bf DS altogether? I really don't want her to have to stop, but I also don't want her to have a gaping wound in her breast until he self-weans (whenever that will be). We need your advice, any and all possibilities are welcomed. Please let us know what you ladies (and maybe guys) think. We'll look forward to your input.

Chris, Ashley, & Ethan

[davi]

hi chris! i am the one that originally started this thread & i have been dealing with this for almost 6 months now...i was also told to let my milk dry up on the side with the abscess but have been nursing only from the other side the entire time...i have had some supply issues as a result of the one-sided nursing, but it can be done. she doesn't have to completely stop BF'ing, but she will have different sized breasts & as long as you are both cool with that, it shouldn't be a problem...i havent had my incision packed for about 3 months now, but the incision site still opens occassionally, but there has been no further signs of infection. i DID wake up the other morning actually leaking milk from that breast (i have NEVER nursed the baby on that side) so, i don't think the milk will dry up completely until baby weans themselves, but like i said, i haven't seen any signs of infection. i guess in my situation, we decided it was worth keeping the breastfeeding going & taking a chance with possible re-infection. i hope this helps & let her know she's not alone with this!

[clittle760]

So did you have to have it re-packed every day then? My wife is already growing tired of the daily visits to the doctor. Basically what they told her is that she can dry up her milk supply, wait for the damaged milk duct to heal and then try to get her milk back. I really dont want my son to subside on formula alone. I am ok with supplementing, but I dont want that to be his only source of nutrition. And why did they decide to stop packing it with gauze? Did you just ask them to stop doing that?

EDIT: My wife just asked me to find out if you also had a broken milk duct in your breast. She wants to know if it will re-heal itself so that in the future with other pregnancies, she can breastfeed and not run into this issue again. We'd also like to continue bf, and he has never nursed off the side with the abscess removed because of the lump near the areola. She only ever pumped milk from that breast.

Chris, Ashley, & Ethan

[davi]

i was having it re-packed every day for about 2 weeks...yes, it's very tiresome, and extremely painful. basically, they want the wound to close form the inside out, which is why they pack it & so that the fluid will drain out as oppossed to accumulating inside, but i am sure you know that. i was told to let it dry up & then attempt relactation, but, to me, it didn't seem worth it as it rakes SO long for your milk to actually dry up, and either way you do it, you run the risk of reinfecting the duct...like i said, i haven't actively nursed from the breast with the abscess at all & i still occassionally get a let-down & am leaking breast milk from the incision site & it's been 6 months that we've been dealing with this. yes, they did cut into a milk duct & the surgeon i have doesn't know how this would affect my future supply for next children. but, i now know, that i can nurse on only one side if need be for my next pregnancy as well. i would suggest contacting a LLL in your area if at all possible. my leaders have been such a help to me. this situation doesn;t happen very frequently, so they may or may not have experience with it, but sometimes just having someone nearby to help you & give some support can be worth its weight in gold! i had my incision in the same area as well, so it was impossible for me to pump or nurse the baby without irritating the incision site. my advice would be to let that side heal & have her continue to BF off the "good" breast. i had a lot of supply issues like i said because of trying to regulate my milk supply with only the one breast & that's where LLL came in very handy! they helped with info on getting me out of pain & having an adequate supply. your wife is lucky to have such a great support system at home as well...keep taking good care of her & your son. holler if you have any other questions! there are a few of us mommas on here that have dealt with this & we have had to kind of find our own way of dealing with the issues as it is relatively uncommon...also, check out the Academy of Breastfeeding Medicine like another mom on here suggested, they may have a different resource in your area for you guys to talk to. i really hope this is helping you out, none of us wants to stop nursing our babes, but it always seems to be the first suggestion we get from most of the medical community.

[Fiercemama]

Jumping back on this thread, even tho its been a few weeks since Chris' first post, I wanted to share some information.

Researchers are finding that milk ducts that have been cut due to trauma or surgery CAN "rechannel" with time, meaning that if a duct was cut while one baby was nursing, with time it may heal and become functional again for future babes. What may have more of an effect on future breastfeeding is whether or not nerves surrounding the nipple have been cut, as they are in part responsible for sending the body the signal to make milk, with stimulation.

Also, there was a good article called "One Breast is Enough" in Mothering a year or two ago, about a mum who nursed TWINS with one breast (and was there a tandeming toddler in there too? LOL) due to a burn to her nipple as a child. Unfortunately the link on the main website seems to be broken. I"ll see if I can figure out which issue its in.

[davi]

hi there fiercemama! so, i took your advice & contacted Dr. Newman & he sent me some info about using ultrasound guided abscess drainage. apparantly that is the preferred method of eliminating a breast abscess in a lactating mother as they can be sure that no part of the breast is damaged that doesn't absolutely need to be & it eliminates the complications that we all ahd such as slow healing time & repeated courses of antibiotic use...so, the good news ladies, is that there ARE alternative treatments out there, we just have to be proactive with our docs to make sure we are using this as a first option. i know i am going to be talking with mine to see if it is an option & if he says no, i'll be off to find another surgeon that is willing to do it this way. thanks again for all the encouragement & great advice!!!