Dear Wise Ones, A lactating mother with a sixteen month old child had a galactocele removed from her left breast on Monday 6/23. It had been needle aspirated at least once before. An ultrasound after the aspiration(s) revealed that the galactocele had a thickened, solid wall. The surgeon wanted to do a biopsy, so the galactocele was removed. The biopsy was negative. The incision was made at the edge of the areola (following the line of the areola) in the 3 o'clock position (if you are looking at her breast)---in other words, the edge of the areola closest to her left arm. The surgeon severed a duct during the surgery, was unable to reattach it, and so tied it off. The surgeon advised the mother to pump or manually express breastmilk from the affected breast and feed it to the child in a bottle---she was concerned that bacteria from the child's mouth would infect the surgical site. The mother doubted whether her exclusively breastfed child would take a bottle, wasn't concerned about infection because the incision was covered with a dressing, and worried that a breast pump or manual expression wouldn't empty the breast sufficiently. Mom decided to continue breastfeeding, and told the surgeon about her decision. Redness and swelling began on Wednesday---by Thursday, the redness was in a crescent shape under the areola, the swelling underneath the surgery site was the size of half of a small plum. No fever. The doctor diagnosed mastitis on Thursday, prescribed Erythromycin four times per day, 500 mg each time. After at least three days of antibiotics, mother has experienced no improvement in redness, but the swelling has gotten worse. Milk has been leaking from the incision since this morning (Monday). The antibiotic has given her a severe stomach upset. She has continued to breastfeed from the affected breast. Mother is wondering whether she actually has a bacterial infection, or whether the swelling and redness is due to the duct being tied off. She would be happy to continue the antibiotic (despite the stomach upset) if it was helping reduce the redness and swelling, but it isn't. She is trying to get an appointment to see the surgeon today, but may not be able to (due to the surgeon's very busy schedule). Any ideas? Rita