Hi Mimi

Can she/partner photograph it and send to you by email - you might be better 
able to assess then??

An ultrasound to find out the extent may be helpful.

I would assume a culture will confirm correct antibiotic treatment.

Wonderful she has been encouraged to continue breastfeeding - I have heard 
of several mums diagnosed with abscesses who have been told they need to 
wean. Luckily they seek a second opinion in many instances. Keeping the 
breast drained well is most important. Some mums have aspiration (even 
several times) and others require surgery.

Thinking out aloud here - could the milky substance she describes be 
breastmilk??

cheers
Del
*~*~*~*~*~*~*~*~*~**~*~*~*~*~*~*~*~*~**~*~*~*~*~*~*~*~*~*
Del Smith
Group Leader and Breastfeeding Counsellor
Southern Lakes Group WA http://www.starwon.com.au/~delma/index.htm
Australian Breastfeeding Association www.breastfeeding.asn.au

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Married to Kevin and Mum to two gorgeous boys Courtney '96 and Dylan '99
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----- Original Message ----- 
From: "Kevin & Mimi O'Donnell" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, October 14, 2006 1:44 AM
Subject: ruptured abcess


> Hi all,
> Working with a mom of an 8 1/2 month old. She has a hx of nipple blebs and 
> one sided nursing. Hasn't wanted help to reduce supply. Since 6 months has 
> started nursing both sides. This mom called me a week ago stating she had 
> lump on left nipple between nipple and areola juncture. This lump was big 
> enough to distort nipple to the left. Described a brown black spot sixe of 
> a pencil dot. Also described a red stripe around top of circumference of 
> areola. Lots of pain with nursing. Enc. her to see Dr that day. Saw 
> midwife who squezzed on area twice causing horrible pain. Midwife felt it 
> was something like a zit!! She prescribed dicloxacillin 500mg 3 times a 
> day for 7 days. The mom called me again on Sunday reporting a low grade 
> fever (she says she normally runs low temp) and reporting that area was 
> oozing yellow pus. Reports after feeding it would open to 1/2 the size of 
> a pencil eraser. Normally it is the size of an eraser when closed. This 
> whole time I am thinking abcess and then as of Sunday ruptured abcess. 
> Encouraged mom to again be in touch with doctor. Doctor also thinks abcess 
> but has not seen her. Extended antibiotics for 3 more days and gave her 
> same cautions I have given in regards to fever, streaking, etc.
> Area is still opening during nursings. Pus has gone from yellow to clear 
> with some blood and is now cream like in consistency and color. Mother has 
> continued to nurse through this. Midwife told her to use anbesol to area 
> beofre nursings, for comfort, which she is doing. She has been unable to 
> "squeeze" any pus out on her own and it mostly just oozes. After nursing 
> area is softer with no hint of lump. Approximately 30 minutes after 
> nursing lump becomes obvious.
> Our questions are:
> Does this sound like a ruptured abcess?
> How long do they usually take to completely heal?
> Is there anything she should be doing that I haven't mentioned or anything 
> she shouldn't be doing?
> I have talked to her about lecithin.
> Thanks for any thoughts
> Mimi O'Donnell, RN, IBCLC
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