Catherine mentioned an article about milk only draining from abscesses when
mother was not nursing or pumping that breast.  This has not been my
experience.  All the abscesses (6-7) that I have personally managed have
drained milk from the incision site.   This scares everyone including the
doctor if all are not warned/educated/prepared for it.  I have a fabulous and
by now very exerienced surgeon whom I refer to.  We've never personally met,
but I think he does a great job and he is supportive of my advice to clients
on how to manage the 'mop-up' phase. In all my cases weaning was not effected
abruptly but proceeded more or less gradually -- generally with a pump, but
in two cases mother kept nursing.  This draining when milk lets down makes
for the need to change a lot of dressings, and this forces mother to have to
keep confronting the frightening visual appearance of the wound. ( I have
some slides that make strong stomachs lurch.)  This is a slow healing
situation -- over weeks.  the range I have seen is 2-5 weeks.  There is a
need for lots of reassurance for mom that this will heal.  She needs rest,
strong immune system -- diet not working too hard, approp. meds. and prob.
for at least a slight wean-down of production of affected size to promote
speedier healing.  BTW, a cool trick if abscess is close to areola where
baby's mouth or pump flange might impinge is to cut up a nipple shield so
nipple pokes through, but silicone donut ring covers and holds down dressing
and keeps another barrier between mouth/pump and bandage.

I, too, like the analogy of walnuts to graphically emphasize the the size and
holding contents of newborn stomach. Sometimes I bring a bag of walnuts to
in-services and pass them out so everyone has one to use as a 'worry bead'
while we talk about early feeding.  Often, if I'm feeling naughty, I will
suggest they 'hold onto their nuts.'

Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin, Tx