Lactnetters,
  I have 2 questions for you:
  What is your experience with the etiology of breast abscess?  and...
  Following surgery to drain an abscess, on resumption of bf, should it be
necessary for a mother to wash her breast and nipple prior to each nursing?

Background:
   A client had a Candida infection on her nipples which finally resolved
with treatment at 6 wk pp.  The left nipple initially had an obvious lesion,
and was so painful that she elected to sometimes pump that breast instead of
bf on it.  At ~10 wk pp, she reported a small, not painful lump in the left
breast; she did not flinch at all when I palpated it 2/25/97.  She had no
fever or other symptoms, and I suggested that she treat as for plugged duct,
watch for developing symptoms, and consider seeing her doctor if the lump
remained unresolved, got larger, or became painful.
  It enlarged to golf ball size over the following weekend and she made
arrangements to see a physician on 3/5/97.  The area was slightly sore and
somewhat pink that day.  Her OB diagnosed mastitis, prescribed Keflex, made
an appointment with a surgeon for the following afternoon (3/6/97), and gave
her the option of cancelling if she was feeling better.  The next morning,
she instead felt horrible, and the lump was very painful.  The surgeon
drained the sizeable abscess that day, having to remove infection from as
far back as her chest wall.
 For the first 48 hrs. following the surgery, she chose to nurse on the
unaffected side and to pump & dump from the affected breast.  On 3/9/97 she
resumed nursing on both breasts without incident or extreme discomfort.
(For several days prior to the diagnosis and surgery, whenever her son would
feed from the affected breast, he vomited up the milk from that breast; no
vomiting at all since the surgery.)
  Her surgeon had the tissue cultured, and reported to her (3/12/97) that
the sample contained staph (nothing more specific told to the mom).  When he
heard that she had resumed bf, he urged her to wash her breast and nipple
before nursings if she "had to" nurse; he really preferred her to still be
dumping the milk.  Mind you, the incision site is far back on the outer side
of her left breast, and she had been bf on this breast for more than 3 days
with no complications for herself or her baby.
TIA  Sara Reuning in Bristol, TN
PS  I'm going nomail as of 3/17 until 3/27, so answer fast!