Dear Wise Ones,
 
I have permission to post.  Mom had severely cracked nipples upon  hospital 
discharge.  She was diagnosed with mastitis 2 and a half  weeks postpartum.  
Had I&D for abcess in left breast.   Incision was made about 3 cms from edge of 
areola at about 5 o'clock  position.  Copious amounts of milk drained from 
wound for three  weeks.  The incision is now mostly healed and it leaks just a 
tiny  amount.  Mom is having little success with pumping this breast, hand  
expression is not very effective either.  Baby will occasionally nurse on  that 
side with a nipple shield.  He did not do well today on the left  breast, 
probably due to little flow. Breast is always very firm.  Reverse  pressure 
softening doesn't really accomplish much.  Mom has not been able  to use moist heat 
very much from the beginning of mastitis diagnosis. Nipple is  very flat and 
won't evert.
 
Mom is by herself most of the day.  Baby has continued to grow well  nursing 
on the right breast.  I have suggested moist heat for 15 minutes  prior to 
attempting to nurse baby or pump and do reverse pressure  softening just before 
latching or pumping or hand expressing.  I wondered  if a breast shell worn 
between feedings would help promote some leakage.   We tried pumping while she 
was feeding baby, but didn't get much.  
 
Mom would like to dry up the milk in the left breast.  Do you think  cabbage 
would help?   The doctor will most likely tell her on Thursday  that she has 
to give up breastfeeding entirely as he feels that the breast will  never 
involute without this occurring.  This is contrary to what I have  read in Jack 
Newman's Ultimate Breastfeeding Answer Book.
 
Do you have any other suggestions for the mom?  She has worked so  hard to 
continue to nurse and her goal is for one year.  Thank you for any  advice. 
 
Mary-Jane  Sackett, RN, BSN, IBCLC, RLC, CCE, CD(DONA)
Registered Lactation  Consultant, Certified Childbirth Educator and Certified 
Doula
Maternal Child  Health Visiting Nurse
Pittsfield, MA


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