I've been involved tangentially with a mom with a "plugged duct".  She'd already talked w/ her midwives and gotten a prescription called in, just in case, but she felt fine, no fever, mild localized discomfort, and nothing had gotten worse for a couple days.  At least not from her descriptions; I've never met her.  She had e-mailed me for additional ideas on reducing the plug, but was already doing almost all the "right things".  

Then she e-mailed me to say that it had gotten "even redder," was swelling visibly... and the skin over it was starting to peel.  Uh-oh.  I urged her to go right to the doctor.  She's now on the right antibiotic and is draining it, and she sent me a picture.  The swelling was so prominent, isolated, and dark that she seemed to have 2 areolae and 2 nipples on that breast.  She still has no fever and no particular pain.  But oh my, what a reminder that phone/e-mail help can miss some mighty important information!

On the other hand, this is the first *developing* abscess I've ever been involved in, out of years of mastitis and plugged ducts.  To what extent do we have every plugged duct come in, and to what extent do we trust that the mom's symptoms are what they seem?  Given the same starting information, I think I'd do the same thing another time.

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com 

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