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I have a mom that when I met at 5 days postpartum already had bleeding cracked nipples. Mom found a nipple shield & felt like it was helping. 4 days later her nipples were worse. I had her try a different size shield & things got much better. Nursing was going well, nipples were healing & then I went on vacation, a co-worker was following up.  Mom got mastitis. When I saw mom again, mom was on her last dose of antibiotics and still had a huge hard mass. We went over how to try to get rid of it, the next day she went to the ER again. They did an ultrasound- diagnosed an abscess, performed a needle aspiration (but didnt get it all) & gave another round of antibiotics.  Mom decided she wanted to quit nursing. I explained to mom it was importnat to keep pumping to empty the breast until the breast was healthy again. On our next visit, mom was feeling much better (post round 2 antibiotics & the aspiration) and didnt want to quit.
Mom saw her doctor again and they aspirated 8cc, culutred the fluid which is no longer growing anything, and have set her up to see a radiologist & have another ultrasound tomorrow.

Mom quit nursing and started pumping when the mastitis was diagnosed. Baby gained 4 pounds in the first 5 weeks! so very healthy milk supply. 

She was told they will needle aspirate it 1x a week for 2 more weeks- if it doesnt resolve they will do an I&D but she will need to stop breastfeeding as they dont want milk leaking through the incision. They've not been supportive and have asked her at every single visit if shes sure she wants to keep breastfeeding. Mom has expressed that I am the only one supporting her. Her husband has been incredibly supportive however when he went to the appointment with her, the doctor went as far to mention as an abscess can lead to breast cancer. Now both are very scared and are questioning in BF is worth it. They are military so switiching providers is not a really an option.

All the literature Ive read indicates even if she has an I&D she should CONTINUE breastfeeding, they should try to make the incision in a fold and start from the chest wall not the nipple, so as not to severe any milk ducts.

Id like to provide her some factual information to share with the surgeon on continued breastfeeding even with an I&D. Can anyone link me to something you would provide a client to share with their surgeon?

Jessica Harper, LLLL, WIC BFPC   (still waiting, 8 more LONG days to see if I join the ranks of IBCLC)

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