I have written on here before - have HCP consider antibiotics again and
add Rifampin 600 mg x 2 doses.  The conference I went to presented by
MD's in the Breastfeeding Clinic in Australia found that this prevented
recurrent mastitis from recurring.  Evidently, some bacteria can "hide"
in breast structures and regrowth occur. Just a suggestion!

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Mary Wagner-Davis
Sent: Saturday, March 22, 2008 7:07 PM
Subject: Recurrent abcess--prevention?

I had a call from a mom today who recently had an abcess lanced/drained.
This is the *fourth* time she's had an abcess in that breast--three
times in
6 months with her first son, now this time with her youngest (who is 3
months old).  HCP told her to call as he didn't think he knew enough
about
breastfeeding to advise her.  His inclination was to say wean, at least
from
that breast.   Mom is a bit reluctant to do so, mostly because she's
afraid
she'll be "lopsided."  My internal response---pllllease, that's the
least of
your worries, honey.  My spoken response was different (I promise).

Children are about 18 months apart, so she's been dealing with an abcess
off
and on since the oldest was 4 months old--3 abcess from time oldest was
between 4 and 10 months old; found out she was pregnant so weaned at the
last abcess.  Now baby is 3 months and she's going down that path again.

Honestly, my inclination is wean from that breast.  *But* if mom doesn't
want to, what preventative measures are there?  I'm thinking the
scarring
from previous surgeries is predisposing her to the plugged
ducts-mastitis-abcess route.  It does sound as if mom has been a bit on
the
slow side in seeking treatment, although she did say this time it
developed
to abcess in less than a week.  What do you all think about using
lecithin
as a preventative for the initial plugged duct?  It's pretty hard for me
to
go along with "Try it, it might work.  You can always risk an abcess
again."

I must say that I've seen more abcess in the past year than in the
previous
10.  What's up with that?

Mary Wagner-Davis, MS, MFT, LLLL, IBCLC

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