Hello all..
I have mom's permission to post.
This mom is one of my prenatal clients here at my job at WIC, she is about 36
weeks gestation presently, due 9/3. She's 22 yrs old, first pregnancy.
She had her nipples pierced shortly before conception, and her right nipple
developed an infection.  On and off since 11/03, she has had a pussy discharge
from the piercing site.  Her OB was reluctant to treat if "if it didn't need
to be" He did sent her to see a surgeon to see if there was an abscess that
needed to be treated, but at the time of her consult, it wasn't pussy, and the
surgeon told her he couldn't evaluate it. She hasn't been able to obtain an appt
during an episode where the piercing is filled with pus.
 Mom can squeeze pus from the piercing site at irregular but reoccuring
intervals.
She hasn't had any treatment of any kind for this infection, not even
antibiotics.  (She removed other ring from non-infected nipple and it healed without
problem)

I encouraged her to contact her OB again...because it seemed to me that if
she had an infection, it should be treated before delivery. (Thinking not only
of healing the infection, but also that she would be better not delivering a
baby with an active infection!) That they should at least try some kind of
antibiotic.

I'm wondering what the collective wisdom of the group is here? I did tell her
that she could breastfeed on the unaffected side without problem...but I
wondered what kinds of obstacles were faced on her breastfeeding from affected
side.  I also wondered, without expressing this concern to her, if she would be
at a higher risk of a breast absess due to the infection.  If she still has an
active infection at delivery, yet not a lot of pain, can she put baby to
breast? (Assuming healthy newborn). If she has to have this possible absess incised
before delivery, what will the affect of this nursing be? Is it a similar
situation to having any breast absess incised for drainage?
I'm also concerned that the lactogenesis process will worsen an untreated
abscess, leading to a potentially very nasty breast abscess, that will put her
off breastfeeding and require alot of medical intervention.
She is going to call her Obgyn again, but I wonder if there is any other
advice I should give her?

Thank you in advance,
June Eastman, BS, M.Ed., IBCLC
Lawrence Massachusetts WIC Program



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