I would be interested in peoples advice on excised breast abscesses.  A woman feeding her 5 week old baby developed a breast abscess (without fever or being unwell), presented to the base hospital and was seen by the surgical team.  Next day taken to theatre and a 4 cm incision made around the areola with a guaze wick inserted inside for drainage.  The mother returned from theatre with a large dressing over her entire breast!  The surgeon had quite missed the point this was a lactating breast!  Anyway we took the dressing down to expose the nipple and then tackled the problem of the  engorged breast.  Baby is feeding well on unaffected side.

It has been a mission to hand express the breast without causing too much pain.  It will be days before she will be able to put a pump anywhere near the breast or her vigorous 5 week old baby.  Any ideas anyone.

Also - trying to find a good handout to give the mother on breast abscess and aftercare.  Plenty around on mastitis but not specific abscess.

Both the mother and I tried communicating with the surgeon about protecting the breastfeeding but were not heard.  This has given me several nights of poor sleep as I think how best to tackle this in future.  3 days into a  new job (hospital based LC)  and already I feel powerless.

Karen Palmer
Midwife and IBCLC
New Zealand



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