Yesterday I was  in to the hospital doing rounds when a nurse asked me to 
consult on a woman 6 weeks post-partum mom who had a abcess on her right 
breast, and was going to have a I and D (insicion and drainage)  The surgeon 
(believe it or not) asked me where to put the incision so she could still 
breastfeed and/or pump.  Sounds great huh?  Keep reading... I explained 
where the flange would need to be placed and could he make the incision 
higher than the flange would go.  The abcess('s ) were two palable lumps at 
12 o'clock and 10'oclock positions right breast.  When she pumped that side 
prior to surgery you could smell the infected milk. The skin was distorted due 
to the swelling etc.  He made the incision close to the aerola border.  Her 
aerolas  were larger than the 24mm size of the flange.  Unfortunately, when 
she returned to her room and I took a look at the breast,  the incision was 
larger than I thought it would be. It was a open 3 to 3 1/2  incision with 
packing inside. I was expecting to see something like the photo in 
the "breastfeeding atlas"  book. The flange would now be right about where 
the skin is open and there is now way she will be able to pump that side.  It 
would be pulling the skin where it is trying to heal.  We banaged her back up 
and I put ice packs around the breast area to help reduce swelling etc.  At 
this point, I don't know how she will be able to remove milk from that breast.  
When talking with the other LC we both agreed she probably is gonna have to 
leave that breast alone  with no stimulation.  Mom is okay with feeding on one 
side only and has a great supply.  My question is has anyone delt with this 
situation before.  Will her affected breast become infected again if we don't 
drain the milk?  She is of course on antibiotics.  Putting the baby to the breast 
or pumping is out of the question now due to pain.  Should we just try to get 
the breast to involute and  just leave that side alone?  Should she try to 
establish milk after she has had some time of healing?  She is being followed 
by a private practice LC and probably home health, for wound care and 
dressing changes. She may or may not get the home health service, since she 
can "drive to the doctors office"  Its all about insurance and cost.   YUK!  I 
have been in contact with her LC and we are giving it our best with a team 
approach.  Any suggestions from someone who has been thru this would be 
appreciated.  You can e-mail me privately or on the list.  Our hearts go out to 
this mom and baby.  What an ordeal they have been through.  Thank you for 
reading this long post.

Best,
Robin

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