I got a call from a husband last night.  Their first baby was born Nov 4.  She developed mastitis in early Dec that never cleared, and she ended up having an abscess surgically drained.  The abscess sounds as if it's well above the areola.

She was told to stop removing milk on that side (!) and has been going in daily for an **excruciating** removal and replacement of packing and drain.  Her husband was calling mainly to see if that level of pain should be acceptable.  Apparently she has to lie on the table for an additional 15 to 20 minutes after this daily procedure to recover from the "torture".  No pain relief beyond Tylenol has been suggested.  Apparently what the packing absorbs is blood and milk.  

She has an appointment with a new doctor for Monday, and now knows to start removing milk regularly.  My question: can she resume direct breastfeeding?  She was apparently put on vancomycin before the culture came back, and it wasn't changed.  The husband thinks cultures are still positive, but isn't sure.  Ruth Lawrence's book says baby can nurse but "the infant should always be monitored for infection, and simultaneous therapy should be initiated, especially with staphylococcal or streptococcal disease."  Makes it sound as if there's significant risk to the baby.  

I've suggested they ask for a culture of milk *from the nipple* if the doctor says the baby can't resume nursing on that side, but would love to be able to say, "Go ahead and resume nursing on that side this weekend."  And I'm very puzzled by this daily excruciating wound care.  Was her original doctor perhaps trying to get this white stuff to stop flowing from the incision, not understanding that it's normal in a lactating breast?  Again, I assume she'll have some better answers Monday; I'm just trying to shorten the weekend for them.

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com


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