Dear LACTNETters,

I am in need of help for a good friend who has recently undergone surgery for 
an abscess, has not been feeding on that breast since surgery and is being 
told that weaning completely is her best option for ensuring healing of the 
site. She has given me permission to post her situation and I enclose her own 
summary of the situation below. I am an anthropologist writing my disseration 
on breastfeeding and sleep arrangements and an avid reader of LACTNET. My 
friend has exhausted her local lactation resources and I offered to post her 
situation to you wise ones - any help would be much appreciated on or off the 
list!

"I am a first time mother to a 5 week old baby girl.  I had to have breast 
surgery on Friday the 19th of October to remove a large abscess (4 cm x 2.5 
cm) from my right breast.  As I wanted to continue breastfeeding the surgeon 
suggested I continue feeding the baby on the left and let the right breast
dry up.  She did not want me to continue to feed the baby on the right
because of risk of infection to the open incision.  The local lactation 
consultant explained that the left breast could eventually provide enough
milk for the baby.  However, the surgeon placed a drainage tube in my right
breast at the abscess site and this tube must remain in place until it stops 
draining.  This is a problem because the tube now drains milk at a rate of
about 1-2 ozs every 2-3 hours.  Every time I nurse on the left, the tube in
the right breast fills with milk.  I can not hold the baby to my chest until 
the tube comes out, which has meant full-time help.  The surgeon plans to
remove the drainage tube on Nov. 6th provided it is no longer draining any
liquid.  As of right now the tube actually drains more liquid each day.  In 
your opinion, is it realistic to expect the right breast to dry up with a
drainage tube inserted while I am still breastfeeding on the left?  Do you
have any idea how long it might take for the right breast to stop draining 
milk?  Any advice you may have would be much appreciated."

Mom reports that as of today the drainage tube continues to drain at a high 
rate whenever she feeds the baby on the other side and the surgeon will not 
remove the tube until the drainage stops. The placement of the tube 
continues to impede her ability to hold her baby. Mom's post-partum help is 
leaving and she is considerably distressed about not being able to care for her 
baby with an open wound and drainage tube in her chest. 
Mom was in a car accident in her last month of pregnancy and received 
lacerations in the breast that later developed the abscess. She feels that the 
tissue may have been damaged by the accident since from early on she 
experienced engorgement, plugged ducts, and felt a lump that eventually 
developed into the abscess. 

My questions are: a) is weaning the only feasible option to resolve her 
continued drainage? I am concerned that the surgeon may discourage slow 
weaning which may lead to further complications; b) if weaning is the only 
option, would you recommend relactation at a later point (how early would 
this be possible)?; and c) are there strategies to quickly reduce and ultimately 
eliminate drainage from that site and continue to breastfeed on the other side?

I am very grateful for your help!

Thank you,

Cecilia Tomori, Doctoral Candidate
University of Michigan
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