The information that follows is being shared with permission from the
patient.

 

Got a call from an LC in a local hospital asking for "another view" on a
situation she has been following.   Baby was born at 32 weeks, discharged at
34 weeks, breastfeeding well, but mother developed mastitis in one breast,
for which she received antibiotics and continued breastfeeding.  

 

Infection did not improve and she eventually was hospitalized with an
infected galactocele.  Unable to drain the breast (pump or baby), they
performed aspirations which removed 25 cc, 100 cc, 80 cc, 40 cc and 45 cc on
subsequent days.  She has been on Keflex then IV zosyn and vancomycin.  They
had to use ultrasound guided draining for multiuloculated/multiple fluid
collections throughout the breast and followed this with binding trying to
prevent the pockets from filling back up.  Her breast continued to fill.   

 

They now seem to believe they have found the right combination of oral
medications so she can be discharged, but mom has had it - every time baby
cries (they have been sharing a room throughout this time), she has a
horribly painful let-down in the damaged breast, and her milk supply on the
other breast appears to be waning.  The pain and postpartum stress has been
very great, and she has decided to stop breastfeeding.  She has asked the LC
to help her stop milk production.  

 

What would be your recommendations?  

 

Jeanette Panchula, RN, PHN, IBCLC

California


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