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permission to post
What kind of physical therapy (US? cold lazer?) is beneficial in
releaving severe induration of subacute mastitis?
Mother 7 weeks postpartum seen on request of her OBGYN for a case of
significant "engorgement" in her L breast of at least a couple weeks
duration.Patient was seen by an outpatient LC who did recommend
agressive pumping, cabbage leaves and hot soaks and by her OBGYN who
started her on antibiotics and did at least 3 sessions of manual
expression with patial success.
First baby was breastfed without major problems, but mother was using a
nipple shield all the time (no comment)
Second baby (the one who is 7 weeks old) is breastfed on R breast only,
with the nipple shild that is too big (will address this issue on the
follow-up appointments). Baby was diagnosed with failure to thrive and
on recommendation of his pediatrician breastfeeding was stopped for 3
days completely (?!) and then artificial milk supplementation was
started. Baby is now receiving not more then 50% of his nutrition as the
breast milk.
On exam L breast was severely indurated with a warm to touch mass size
of a good fist just under the areola, not movable, painful on palpation.
nipple was retracted, overlying skin erythematose with bluish
discoloration, some peeling noted. Emergency US in the local breast
center consultation revealed severe mastitis and 3.5 cm abscess. Breast
surgeon did not see any indication for surgical intervention and
recommended to continue with present care.
I definitely will show mom how to use the electric toothbrush (did not
want to touch her without ruling out other, more nastier causes of
induration...), but would like to be a little bit more aggressive in
this case.
TIA,
Alla
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