Wounds from breast incisions usually heal even if a mother is using it to
breastfeed. What would be the benefit of engorgement or mastitis on the
healing breast? I do not see any reason, myself, unless the mother wants to
wean.

What is the documentation that says it that she has to stop bf? I am not
understanding this MD's advice.

From Auerbach and Riordan 's book, BF and Human Lactation, 1993 edition, p.
396, "With abscess drainage, lump removal or biopsy, there is usually no
reason the mother should stop breastfeeding. The exception is the case in
which a perioareolar cut inferferes with the nerve supply to the nipple,
severs milk ducts, and leads to lactation failure. (Day, 1986, Neifert eta
l., 1990). ...Protocol at the Lactation Clinic in Los Angeles, however,
calls for continued feeding on the affected breast as long as the
incision/stitiches are dorsal to the nipple and areola, and the mother does
not find this objectionable. ( Marmet and Shell, personal communication,
1991.)...If the wound is left open to drain, bf can be 'messy,' as milk and
other body fluids may leak from the ducts. The mother should be prepared to
replace soiled dressings with clean pads. Milk leaking from the wound may
slow healing. As a result, the mother is at risk for a breast infection or a
milk cyst; a low-dose prophylactice antibiotic is sometimes used to avoid
infection....."

From Ruth Lawrence, p. 265, she refers to surgical drainage of an abscess. I
realize that this is not the same as a Fibroadenoma,  and as such, Dr.
Lawrence's advice here about abscesses and surgical drainage might not
apply.  However, I am curious to her reference to surgical treatment of the
breast abscess....

, Dr. Lawrence indicates that after surgical drainage, a breast should be
treated with antibiotics, rest, warm soaks, and complete emptying of the
breasts every few hours.  p. 266 states that " Nursing can be maintained
when the breast is surgically drained as long as the incision and drainage
tube are sufficiently far from the areola so that they are not invovlved in
feeding. In any event, the breast should be manuyally drained of milk freq.
to maintain the milk supply until feeding can resume (usually sufficient
healing takes place in 4 days.) The infant should be monitored for
infection......and simultaenous therapy should be initiated, especially
iwith staphylococcal or streptococcal disease. ....With adequate systemic
antibiotics and careful but thorough draining of the breast by suckling or
pumping, healing gradually takes place  even while the mother continues to
lactate. A 'butterfly' bandage can be used to bring the edges of the
incision together once the abscess iss completely drained (3-4
days)......Rarely is weaning from the involved breast necessary."

Even though fibroadenoma is not abscess, it is treated surgically, and I am
at a loss as to why a mother who does not wish to wean, and who feels that
she can handle breastfeeding, and who is being treated with antibiotics,
etc, must wean? Why does she have to wean?  What is the deal? References on
this?

Kathleen




"rom:    "Barbara Petzoldt,  LLL Leader" <[log in to unmask]>
Subject: Re: Fibroadenomas and Breastfeeding

Did an archive search and only found one mention of this,  but not needed
information.

A mother had a Fibroadenoma surgically removed a few weeks ago.   Incision
made around part of the Areola.   Dr.  advised against using that breast as it
drainded.   Mother started supplementing with bottles.   Can't pump on that
breast, as manal pump hurts the breast incision.    Not using this breast.
Complained to Doctor this week,  and he drained milk from incision area.
Told her she needed this wound to heal and would probably have to wean
entirely for
this to happen.

Any ideas?    Mom sees Doctor again the beginning of week and doesn't want to
wean!     I don't understand the reasoning for not just nursing on this side
and keeping wound clean.

Barbara Petzoldt,  LLLL, AAPL/MO,  WIC Peer Counselsor
Fenton MO
[log in to unmask]"

Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
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