Barbie,

Off the top of my head, going strictly by your description, I'd say ice
packs for 30 minutes, as often as every 2 hours or so when desired, to
numb the area and relieve swelling till 7-10 days postpartum and see if
it resolves to what is normal to her. Is this her first baby? Did it
enlarge during pregnancy?

I read in one reference where 50% of the milkmaking tissue is in the
upper, outer quadrant of the breast, which includes the tail of Spence.

It is also possible that she may have some supernumerary breast tissue
there, too, as I have read where it is possible without having a
supernumerary nipple.

Did she have several bags of IV fluid during labor? This area is very
close to the numerous lymph glands in the axilla. Is the swelling more
like tissue fluid distributed throughout most of the swollen area? In
that case, gentle inward, upward massage in the direction of the lymph
flow might be helpful.

Remember, this has to be explained to her, because mothers usually think
of massage as downward in the direction of milk flow.

Or is there a definite "ball shaped" tender place underneath? What are
they proposing to do, having diagnosed breast abcess so early in the
postpartum period? Antibiotics? Certainly not surgery with no more signs
of infection than you have described!

In the last analysis, asking these questions thoughtfully and giving her
your impressions and recommendations about comfort and about getting off
to a good start at breastfeeding is the starting point, and perhaps the
ending point of what you can do.

A lot depends on what kind of a relationship you have with the docs, and
no matter how irate you may be, remember, the issue is not about you
needing to vent your emotions to the client, the staff or the docs, just
to Lactnet!

It is really about  working with her to facilitate her initiation of
breastfeeding, and with her physicians to investigate other possibilities
long before surgery comes under discussion.

Keep us posted.

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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