Hi.My name is Christine Choong & I work in Malaysia as a Lactation Consultant & Childbirth Educator. I have been off lactnet for a while as I am having many problems with both my computer & my e-mail. I would like some advice for one of the mothers who attended my ante-natal classes. I have her permission to post this.
As a little backgound, she delivered by LSCS after a prolonged labour. I saw her initially in hospital as she had difficulty with attachment but I have not seen her personally since.
It seems that following delivery she had a rupture of her bladder twice & had 2 courses of antibiotics. the second being Augmentin. She has a known sensitivity to penicillin & reacted to this medication.
3 weeks after delivery, she was using a nipple shield & noticed that she had fresh bleeding from her right nipple (enough to fill the shield) and this persisted for a few days.She had no cracks on her nipple.
Week 4 she developed a lump above the nipple/areola in her right breast & experienced a pinching/tight feeling in the breast when feeding.. This did not reduce with normal management for a blocked duct & the lump grew to the size of a golfball. She has no redness or tenderness over the lump. The midwife who saw her referred her to a breast surgeon. The breast surgeon aspirated 20 ml of pus & blood. She prescribed Augmentin & told the mother to stop breastfeeding - the mother declined both of these suggestions.
A mammogram & ultrasound were performed.  The radiologist informed her that the lump contained a mix of fluids & solids & said he had never seen anything like it before.
She was seen by a second breast surgeon (generally considered to be the breast expert in Malaysia). She again aspirated pus. She again queried that it was a blocked duct containing pus & dried blood.  The solid area remained after the pus was drained. She offered to do a biopsy if the mother wished ( this suggests to me that she personally didn't think there was anything sinister or she would have proceeded with the biopsy). The mother has fibrocystic changes in the left breast but none in the right. Two members of her family have been treated for breast cancer.
She has since been seen by an acupuncturist who again feels it is a blocked duct. She is treating her with acupuncture & belladonna.
There has been no reduction in the size of the lump, neither has there been any discomfort from it. 
Is anyone able to offer any advice on the management of this. If possible please could you answer to my personal e-mail as I am still have difficulty downloading any large documents.
Could you send to either [log in to unmask] or [log in to unmask]
Thank you in advance.
Hope all is going well for those studying for the exam next month.
Best wishes,
Christine

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