I have gotten only very few answers on this post, and I know there were
problems with the delivery of this message, so I'm posting this again.
Those of you who have read this - skip it. Sorry for the inconvenience, but
I would really like your help.

Thanks,

Mira

>Hello all,
>
> I need you collective help again. The story is a bit long, and maybe I
don't have all the details, but I would still like to hear your advice. I
first talked to the mother today.
>
>Primipara, baby 3 mnths old. Nursed with nipple-shields for the first 5
weeks because of latch-on problems, then weaned from the shields, and is
nursing exclusively. No sore nipples.
>
>At 4 weeks first breast infection, went away with plugged duct measures
(maybe that's what it was), a few weeks later the same again, and a few
weeks later again the same symptoms, and got antibiotics this, third or
maybe fourth, time. A while later
>a big lump develops in the breast, no fever, not tender. Was diagnosed as
breast abcess, drained under general ansthesia, and mom given
Amoxycillin/Clavulanic acid.
>
>Now, about ten days later, still under antibiotics, another lump in the
same place, again no fever, not tender. By ultrasound another abcess. I
don't know wether this is a recurrence, or maybe the first abcess wasn't
drained completely, and just filled up again. Maybe this is a Galactocelle?
How would you differentiate the two?
>
>So far mom has been nursing on the unaffected side, and pumping and
dumping from the side with the abcess. She has been told that unless she
weans completely from both sides this will keep coming back. She very much
wants to go on bf, and is willing to do so from one side only, if
necessary. Today she will be seeing another surgeon about the lump, but so
far all the surgeons she has seen, checked her for two minutes, and said
she has to wean. She is afraid that's what she's going to hear again. None
of the surgeons was even mildly interested in her desire to go on bf.
>
>Any ideas - why would the infection come back time after time? Could there
be an anatomical problem? If so, how could it be diagnosed?
>Can she nurse from the affected side? Could a culture of her milk help
answer this?
>If they culture her milk - how many bacteria would be OK to feed a healthy
3 mnths old?
>Does she really have to wean from both sides? I don't think so.
>How to differentiate an abcess from a galactocelle?
>
>Any help appreciated.
>
>Mira Leibovich, MD
>Family practice
>Israel
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