Nipple aspiration can be repeated until the abscess resolves. If the mom does have an incision and drainage, and the wound is near the areola,  transparent film dressing (Tegaderm, Clearsite) can be used to protect the incision from baby's saliva and improve maternal comfort during feeding or expressing. 

Catherine Watson Genna BS,  IBCLC

Sent from my T-Mobile 4G LTE Device


-------- Original message --------
From: Arly Helm <[log in to unmask]> 
Date:05/08/2014  7:01 PM  (GMT-05:00) 
To: [log in to unmask] 
Subject: mid-abscess ponderings: how to improve the situation 

An abscess has been drained twice by needle aspiration (four days apart; most recent was four days ago), and she is on her third antibiotic (amoxicllin -> Keflex -> clindamycin). The milk was cultured and was positive for Staph (specific species not mentioned).  If there are any signs of the abscess in four days from today, it will be surgically drained. What can be done now to improve her chances of successfully avoiding the scalpel? She had relief from each of the two previous needle aspirations; is there a clear indication to move forward into surgical drainage, or would a third needle aspiration be preferable?

Still wondering about the fibrous tissue of the encapsulating abscess wall. Will engorgement treatment be helpful--frozen peas, cold cabbage, etc.?

So far, the dr has told her "most women want to stop breastfeeding" after surgical drainage, "because it leaks." Also, that the milk should be pumped out of the affected side and given by bottle for two days following needle aspiration (not dumped) because he doesn't want the baby's mouth "to introduce new bacteria." In response,  I gave her printouts of the ABM protocol ("After surgical drainage, breastfeeding on the affected breast should continue..."), Breastfeeding for the Medical Profession, and Riordan/Auerbach (did not find instructions on bf after drainage in Riordan/Wambach).  She may share these with her dr or just read and recycle. 

Arly Helm, MS, IBCLC

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