Pat,
I certainly agree with you that "Nursing is the most efficient way to remove
the milk and prevent further complications in that breast." However, I find
myself respectfully questioning your statement: "One sure way to progress to
an abcess is pump instead of nurse!" As someone who has worked with
thousands of pumping mothers, many who have chosen to pump and bottle-feed
breastmilk, I have never once seen pumping during mastitis lead to an abcess.
Assuming she is using a hospital-grade electric pump, I do not believe
pumping puts a mom at such a risk for abcess that it would be called a "sure"
thing, nor do I believe there is any research that backs this up. Instead it
is NOT pumping that would be the sure way to progress to an abcess. Ruth
Lawrence's recommendations for managing mastitis include: "Be sure to empty
the affected side by feeding or pumping." (Breastfeeding: A Guide for the
Medical Profession, 1994, p. 264). Riordan and Auerbach also mention
research showing "Treatment involves getting the milk to flow with heat,
expression, and pumping." (Breastfeeding and Human Lactation, 1993, p. 383).
It makes me furious (as well as sad) to read that doctors are still telling
women to pump and dump during a bout of mastitis, but I remember when it was
a very common occurrence. While I have always tried to get information into
the mother's hands concerning no need to stop nursing, many would not go
against their "doctor's orders." Consequently, I have worked with a number
of women who have pumped through an infection. None ever resulted in an
abcess. I realize this is only anecdotal and just my experience, but I am
wondering if this has been unusual, i.e. the moms I worked with have just
been lucky? Do others agree that this is a "sure" progression? Do we have
evidence?
Cher Sealy, RN, BSN, IBCLC
Montgomery, Alabama
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