I've been lurking on LACTNET for a few months but this is the first time
I've posted. I have just completed training to be a breastfeeding counsellor
with the Association of Breastfeeding Mothers in the UK. I also run a mother
to mother breastfeeding support group locally.

My query is about a problem one of the mothers in my support group has. She
has had a large lump (bigger than a golf ball) in the upper part of her
right breast for 7 weeks. Her baby is 13 weeks old. She first noticed the
lump around the time she began expressing milk and breastfeeding lying down.
Two weeks after the lump appeared she developed mastitis (hot, red area &
flu symptoms) which was treated with antibiotics. The red area cleared up
but the lump remained.

The mother has tried repeatedly to massage away the lump assuming it was a
plugged duct but couldn't clear it. Two weeks ago she went to see her GP who
prescribed another course of antibiotics for mastitis. The mother didn't
take them because she didn't think she had mastitis (no redness or flu
symptoms). The skin over the lump looked slightly bruised (possibly from
massage).

Yesterday the mother had a hospital appt where the lump was checked using
ultrasound. The doctor said the lump was an abcess and drained it using a
needle. The mother started another course of antibiotics and goes back for a
follow-up check next week. Is it possible to be certain this was an abcess
from ultrasound and draining fluid? Could it have been a galactocele or is
that unlikely?

The mother would really like to keep breastfeeding, but doesn't want a
repeat of the abcess or any other problems, especially since she is
returning to work part time in a week or two. The hospital doctor told her
that continuing to breastfeed would mean the abcess is more likely to recur
than if she weaned completely. Is this true - have studies been done? If the
abcess is likely to recur on this side, would it be possible to wean off the
affected breast and let it dry up and feed just from the other breast? The
doctor told the mother that any breastfeeding would mean both breasts
continue to make milk but I thought this was not the case?

At the moment, the mother hasn't breastfed or expressed either breast since
yesterday. I have suggested she express, at least to comfort, to avoid
getting mastitis in both breasts from engorgement.

As I said, the mother would prefer to breastfeed but will continue with
total weaning if it means less likelihood of another abcess. She also
doesn't know whether the original blockage has cleared and how to shift it
if it is still there. Can anyone give me some information and suggestions to
help her?

Sorry this is so long. I'll have to work on writing succinctly!

Kath Monkhouse
Association of Breastfeeding Mothers bfc, Vale of Glamorgan, UK

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