Greetings,

I would really appreciate some input regarding a call I just received
(haven't seen mom yet, permisison granted to post).  Mom is primip, 21 year
old, baby boy born 1-7-04, nursed well from start, no infant problems.  Mom
plagued by health problems since delivery, first wisdom teeth removal, then
episiotomy or vag. tear site not healing, needed repair, and most recently
surgery for a breast abscess.  The odd thing is, the abscess was not
preceded by a known plugged duct or br. infection, and the abscess caused
no pain beyond slight tenderness.   Abcess was surgically drained (after
initial aspiration) and has a wound which mother has been instructed to
keep open for a month.  Mother was instructed to not breastfeed for 24
hours (anesthesia! grrr) and resumed breastfeeding after that time.  She
cannot pump, because the flange hits the incision site.  So, other than the
24 hours of milk statis on the affected side (mom pumped and dumped good
side), milk removal has continued fairly normally.  The problem is that now
the incision site is looking red, and so she went back to the phys. today
who said site is fine, no infection, but another abscess appears to be
forming behind it!  They did culture the pus removed from the original
abcsess and mother is on antibiotics which are presumably appropriate,
although i do not know what grew out.  Other possibly relevant
history  -  mother has had chronic candida problems, and is currently
complaining of a sore throat, but doctor doesn't feel candida is an issue
and mother has no symptoms of breast/nipple candida.

Beyond frequent milk removal and continued antibiotics, what would you all
recommend?  Why would this mom be getting abscesses?  And  is it common for
abcsesses to be relatively painless and not preceded by any type of
infection?   in Core Curriculum, it states that abcsess can be a
complication of mastitis.  I know  mastitis can be afebrile, but painless
as well??

thanks in advance for any guidance,


Lyla Wolfenstein, B.S., IBCLC, RLC
email:  [log in to unmask]

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