Mastis/breast Abscess-I have ?'s

[TrishWSU]

After struggling with plugged ducts for 4 weeks I have developed mastitis and what looks like an abscess. I started on anitbotics yesterday and already some of the redness and the hard lump I've had for weeks is going away, but the abscess part is extremely painful-raising my arm or slightly bending over causes excruiating pain in my breast. So now for my questions:

Will the anitbotics clear up the abscess or does it have to be surgically drained?

Is the milk I pumped from this side safe to give to my surro son {I'm an EPer}?

Should I be using warm or cold compresses on the abscess?

The little bit of information I can find online provides opposites answers for these of questions. I have a follow up appt w/ my doc on Wednesday, but if the abscess will need to be surgically drained I'll try to get seen tomorrow or Monday. The pain is really interferring with my daily activities-I'm a diaper sewing WAHM and it's really difficult to trace my pattern and cut fabric when I can't even lean over.

I hope someone can help! TIA!!

[meowee]

Maybe someone else can give you more hopeful advice, but my abscess never went away by antibiotics. I was just about to start testing and possible surgery when I got pregnant again and my milk dried up, and the abscess went away (I continued to feel a slight lump until my milk returned after giving birth, then it was 100% gone). I had a chronic infection and was devastatingly sick. You can use hot and cold compresses, and castor oil packs, but honestly I was in such severe pain that those things barely put a dent in it. I would suggest the largest dose of ibuprofin that a medical person will allow you to take, too. That is better than tylenol b/c it is anti-inflammatory.

Is the milk safe? I was told conflicting things too. I did breastfeed my daughter throughout all my sickness and she seemed ok. But one dr sternly warned me not to.

I'm sorry you're going through this . If I could go back and do it over, I would have weaned (I actually tried but had such oversupply it was impossible...). I was not able to function either and basic tasks like walking up the stairs became huge chores that I had to plan carefully in advance. I could not carry or lift my children. I would rather have weaned and been able to carry my kids and function and not be in constant pain.

[jaidymama]

From all that I've ever read, I would bet it's safe to continue EP'ing... You may want to check with your LLL leader. You can find a contact by visiting their website:
http://www.llli.org/resources.html
http://www.llli.org/webindex.html

As for treating your mastisis, are you I would get a second opinion..

[LLLHeather]

Trish,

I would suggest a few things for your condition. One thing I would definitely recommend is to find a La Leche League group in your area to become familiar with the Leaders and meet some mothers who are giving their babies breastmilk. Mothers who exclusively pump have special challenges and are very welcome at meetings and you could probably use the support.

The Breastfeeding Answer Book says, "Breast abcesses happen rarely. When they do, they are usually the result of untreated mastitis, a delay in treatment, or incorrect treatment. The abcess-a localized collection of pus-forms in an area of the breast that has no opening for drainage and so it must be surgically drained to the outside. It is a serious and painful condition that needs immediate medical attention."

Sometimes your doctor can confirm the abcess by exam alone. Mammogram does not calrify the difference between abcesses and other masses. Ultrasound preformed by an experienced tech familiar with the lactating breast has been found helpful though in distinguishing abcesses. If the location of the abcess can be confirmed before attempting drainage you can avoid unnecessary incisions in the breast. Breast tissue is very delicate and the tech and doctor should be gentle with it so as not to create further damage to the breast.

"A breast abcess requires surgical treatment with antibiotics and rest, but in most cases breastfeeding can continue." You can definitely nurse on the unaffected side and if the baby's mouth (or pump in your case) doesn't touch the incision you can nurse on the affected side. This will not prevent healing.

As for the mastitis, antibiotics alone will not elliminate it. You have to do some things to remove the clogs (to prevent further abcesses). First, you have to REST! This is extremely important. You need to massage, a lot! Do this about 8-10 times a day as often as you think about it. Use as much pressure as you can stand. Sometimes it helps to use the back of an electric toothbrush or a comb to massage too. Start at the clog and massage out toward the nipple. You may see some of the clog coming unclogged, might look like a thin strand of spaghetti, might look a little like pus or thick milk, could be yellow, have a tinge of pink, red, or brown. This is all normal and okay, just a little blood and won't hurt your baby, no need to discard it. Apply heat to the breast before feeding/pumping and massage to help loosen clog. Nurse or pump on the affected side as much as possible. Vary nursing positions, baby will remove the most milk from the area in which his nose or chin is pointing. High doses of vitimin c are shown to help (5000-6000 mg of high quality c like EmergenC brand) until you reach bowel tolerance. You really have to do all of the things to make sure it goes away and doesn't quickly return. Hot showers and baths can help also.

If it is truly an abcess the lumps won't go away and won't lessen. I would have an ultrasound like the Breastfeeding ANswer Book suggests to confirm. It will take several days to get rid of the clogs so you need to take your baby and go to bed for at least the weekend, stay home and away from sick people (this contributes to clogs), avoid added stress, rent some movies and order in. I know it is a holiday weekend and there may activities planned but this is more important to take care of!

I would also suggest avoiding all dairy. Because of the hormones and anitbiotics in it our bodies response to that is the manufacturing of pus cells. This causes sickness and seems logical that since an abcess is a pocket of pus you might be better off not consuming it.

Also, if you need to have a medication checked you should call a LLL Leader to look it up in Medications and Mothers Milk. Almost all medications are fine but sometimes doctors tell you to pump and dump without reason.

Heather

[meowee]

My experience was that the abscess did lessen a little with antibiotics, but it never went away. I was constantly sick, but I had periods where I was less sick than other times.

One thought I had-- if the milk is septic, it might be worse if you are pumping. Even a small period of time between pumping and feeding, even if the milk is in the fridge, will allow the bacteria to multiply a great deal. I have never been able to pump so I'm not sure about this, but theoretically the milk could turn septic faster than healthy breastmilk.

[PatioGardener]

Abcesses are nasty. I hope yours is a plugged duct that clears, but if it is an abscess, it will probably have to be drained. Sometimes they can be drained with a needles (and repeat drained every couple of days until they go away) and sometimes they need to be opened surgically and then drained. If that is the case, the doctor doing the procedure needs to know you are lactating, and will then make the opening in a way to damage as few milk ducts as possible. From what I have read, that is an opening that radiates out from the nipple and not a cut 'around' the breast or the areola.

Jack Newman says that a breast abscess is not a reason to stop breastfeeding. http://www.drjacknewman.com/index.ph...101&Itemid=141 He doesn't mention pumped milk, but moms here say that he answers emails, so he may answer if you email to ask him.

hope you are feeling better soon!

[TrishWSU]

Thank you all for the replies. I really haven't found much about what an abscess actually is but I'll describe mine. At 10 days PP my right breast became very painfully engorged and I was running a fever. After putting some cabbage leaf on it I was able to massage it and started pumping out colostrum again and the strings of milk fat. Then my supply dropped off to only 1/2 oz per pump and I could feel another plug forming. Over the last 4 weeks it's become a very large hard lump (like the size of a kiwi) in my breast and I did all the recommended stuff to get the clog out. About a week ago my breast started getting red and hot (the mastitis starting.) After starting the antibiotics on Wednesday the large hard lump in my breast has started to go away, but there is a soft sort squishy lump (a little bigger than a quarter) that seems to be just under the surface of the skin. That is that part that is extremely painful. I can't even wear a bra or lean over without causing myself some major pain, so I don't want to try to massage it. I guess I will keep trying with the warm compresses before pumping, though.

I think I'm am just going to pump & dump on that side. I have almost no supply anyway-yesterday I only got 3 oz in a 24 hour period so it won't be a huge loss. Fortunately my left side produces about 30 oz a day and that's about what my surro son eats in a day (he's such a fatty, lol!)