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