Hi All,
I’ve been eager to post an update on the mom I’ve been helping all
weekend. Thanks to all of you who replied on- and off-list with all sorts
of helpful information and ideas.
From others’ replies and from my own observation, I was pretty sure we
were dealing with a subareolar abscess in mom’s right breast. The mom and
I were both on the phone first thing Monday morning trying to convince a
doctor, any doctor, to see her (it took a LOT of convincing, I'm sad to
say). Finally she got an appt Monday afternoon with a surgeon and she
invited me along (made my day, my week, etc.!). He immediately did an U/
S of the breast (I was so excited!) and found NOTHING but very densely
engorged tissue -- go figure! I was SO hoping to find an abscess that
could easily be drained on the spot, she could finally relieve the
engorgement in that breast, angels would sing, and they would all live
happily ever after…but it didn’t happen. It was all just very densely
engorged tissue.
Doc tried a random aspiration (sans local anesthetic) by just poking a
syringe in here and there and pulling back the plunger, hoping for at
least a little pus for culturing, but found nothing but blood. He offered
to prescribe a stronger antibiotic than the 500 mg qid Ampicillin she had
been taking for the past four days. He admitted he wasn't familiar with
breastfeeding-friendly antibiotics, and I kicked myself for not toting my
2006 M&MM with me. Anyway, allowed me to phone in with some suggested
antibiotics, which was a good thing because both of the antibiotics he
wanted to use were L3, and this woman's baby was only 10d old. I
suggested Keflex and Dicloxacillin and the doc went with 500 mg Keflex; he
said he was hesitant to give another drug from the penicillin family since
the Ampicillin hadn't done a whole lot (I'm thinking the low dosage didn't
help either).
I just talked to the mom and she's been taking the Keflex for 48h. She
said she can't see ANY improvement in the pain or firmness of that
breast. She has had wonderful success pumping her L breast 8x/24h; I even
wondered if those MER’s were exacerbating the congested breast. She did
an epsom salt soak on that breast last night and was able to peel off the
callous that had formed at the tip of the breast, and the bacterial
infection on the nipple seems to have cleared up. She is eager to try
pumping and I didn't see the harm as long as she reacted accordingly to
how it feels and acts. This is what is known as a caked breast, I suppose?
I’m ready to suggest alternative remedies – or any remedies that will
help! Some of you have suggested a few homeopathic remedies and some
different poultices, so I'll compile the list and offer it to her if she
wants to give any a shot. Any other suggestions to help speed her
recovery?
Thank you all again for your support and wisdom.
Debbie Gillespie, IBCLC, LLLL
Tempe, AZ, finally down into double-digit temperatures!
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