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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