Dear Lactnet Friends,
I am writing to ask for advice on comfort measures I can offer a client who
had a biopsy 48 hours ago. She is currently nursing a 2 year old and
discovered a lump. On Friday she went to the surgeon for a needle aspiration.
Surgeon was unable to get much fluid so went ahead and also did a
stereotactic biopsy. The process resulted in a fistula and a golfball sized
hematoma directly under the nipple at 6:30 position and toward the armpit. MD
says he doesn't know if he got enough fluid or tissue and may want to redo
the biopsy if results are undetermined. In the mean time, mother is very
sore. So far she has not put baby or pump to the affected breast and is
becoming very engorged and lumpy. She is still nursing on the other breast. I
have suggested nursing or pumping to prevent mastitis, also cabbage for
swelling, heat to move the lumps, flexishield use with gentle pumping to
reduce pain.  Riordan cites using a cut away nipple shield (donut shaped) to
protect the area, does anyone have experience doing that? MD says no
ibuprofen for 7 days due to hematoma, only acetaminophen. She is in a lot of
pain.
       Thank you for your input.
Judy Gutowski, IBCLC
Western PA where we currently have the first accumulation of snow for the
winter, about 3 inches so far and my sick children are sitting in the window
wishing to go out.

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