Mother presented to the ER last Wednesday and was diagnosed with Mastitis. She was prescribed medication and sent home. She was still nursing on that side but the child started to refuse it and then she started pumping she started to get less and less milk out. Mother then reported back to the ER on Sunday when the mastitis which was originally located in the top corner of her breast moved downward and she wasn’t getting any better. She was then switched to clindamycin. She came back today because the medication is not helping any and no she has been unable to remove any milk from that side and her daughter will not latch at all. My observation: Breast is clearly red all the way around the areola about 1-2 inches back. About the size of a baseball completely around nipple. The skin is starting to peel because it is being pulled so tight. There are no areas that are firmer then the rest (no noticeable clogged duct) all the red area is firm. Mother states that she has tried showers, massage, pumping, relaxation and continually trying to get her daughter to nurse but she is unable to get anything out of the breast.  She does have one area about the size of a nickel subareolar that is mushy and appears to be filled ( ? abscess). My question is how can I help her to remove the milk. I did try RPS, massage and warmth but I got nothing – not even a little speckle of glistening milk. 

Jessica IBCLC
NC, USA

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