I want to share a success story and sing the praises of a center in my area.
A client contacted me with symptoms of an abscess.  She had already been
working with a local midwife and had been on antibiotics for two weeks.  She had
reached the point where if she was supposed to always hurt, she didn't think
she could keep breastfeeding.  I won't go to the angry place I feel about the
care she received before calling me, though if anyone can share a nice way to
say "HELLO!! THAT IS SO NOT THE PROPER CARE" I may be able to discuss it calmly
at a later date.  Haha.  But, the impoper care is not the story.   Anyway,
over the phone I told the father I really would not be able to help since from
his description she really needed to see a doctor immediately. I actually told
him to go to the emergency room because this was not something I could fix.
No.  The wife insisted on seeing someone who would know about breastfeeding and
know what to do.  Okay, I went.  My goodness am I glad I did.  The nipple had
a scar so deep it had split the nipple even though it was healed.  The nipples
were soooo pink and with 2 weeks of antibiotics that is likely thrush (we'll
deal with that next) and her breast, oh, my.  Could have been a slide for a
classic presentation of a breast abscess.  The baby was 6 weeks old and mom had
never had a single feeding pain free.  Not one.  We talked about what lead to
the abscess and what had been done to 'treat' a massive infection...oops my
anger place  will slip, better not go there. Haha.  Then her baby woke up and I
wanted her to show me how she nursed.  It actually hurt me to see him latch
and chomp and his upper lip totally tucked under, eeks.  He has a labial
frenulum --- as did his mommy until her recent surgery for it.  He can keep that lip
out when you do it for him, so maybe it will stretch??  He barely had her
nipple in his mouth never mind her breast.  He was growing like crazy because he
nursed forever all the time and she has a decent supply of milk.  (The supply
coupled with the nipple trauma coupled with the lack of complete emptying
probably lead to the abscess in the first place.)  Okay.  I explained latch, showed
her where he needed to be--oh, imagine her surprise when he came off and her
nipple was not pure white.  He is not thrilled---liked the old way, but he's
young, he'll learn.  And she will be sure he does since pain free nipples is
such a great thing.

 Now the part that made my day.  I go on a search for a doctor who can help
her.  She doesn't have one and I wanted someone who would not hurt the
breastfeeding she has suffered to maintain for 6 weeks.  After asking several people,
no one had anyone they would trust to not tell her she had to wean.  I called
an OB friend of mine to ask if he could please recommend someone and he gave
me a couple of names, but they did not have any openings and would only see her
if he called personally and then they may be able to squeeze her in.  I
called him back, and explained the situation.  He said  "call the Aventura Breast
Center, if anyone can do it, they can."  I did not want this mom trying to
explain what she needed, so I called myself and talked to a technician who said
"oh, we just did this recently---we did needle aspiration guided by ultrasound,
the mother came back a few times before it totally resolved, but she never
stopped breastfeeding."  YES!  I had found a place for her.  I spoke to the
doctor who would see her, and explained what I saw. (Teased her that I am not a
doctor and cannot diagnose--she laughed and said, so describe. Hahah) She said,
okay, send her in now.  I called back the original doctor who fit into his
already booked schedule what needed to be done to get her there. The center  saw
her during their lunch!  This amazing woman, this wonderful doctor, fixed it.
They found a 5 cm abscess and removed 50 cc of pus.  The lab has it now and
results this morning should let us know what antibiotic she will need.  When the
doctor phoned me after the procedure to tell me what she found I let her know
that it was a gift to know that there was a place in S. Florida that
understood the lactating breast and was comfortable caring for it. The mother could
put her arm down, she could breastfeed pain free, and even though she may need
to repeat this procedure, it is so much easier than the surgical option.  I was
given such a gift personally.  My distrust and often disgust with the medical
care in my area often makes my work so difficult. Today I was able to see a
glimpse of what practicing medicine should be about---healing.  It was truly
wondeful to be witness to two doctors take a step above and beyond to preserve
breastfeeding and to help this one mother and baby.

I just had to share...
Pam MazzellaDiBosco, IBCLC, CD(DONA), CCCE
Birthing & Beyond, Inc.
Florida, USA

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