<If her milk is still draining from the drain sites on friday the Dr's are
going to insist she wean and I think she will go with that. Does anyone have
any info on shutting down one breast. I have read theinfo from Ruth Lawrence
on breast abscess.I would appreciate any input you have on this. Nuala
Murphy>

Nuala
I am still carrying guilt about a mom I was seeing with mastitis that
developed into a breast abscess (one of a spate which invaded Cape Town last
year). I had seen her very early pp with difficulty in latching, engorgement
and nipple trauma of her L breast. Both nipples were inverted but the L
breast never seemed to have a strong or easy flow of milk.

At 6 weeks pp, with breastfeeding going well at both breasts, she developed
a painful lump in the L breast, which seemed to resolve with homeoepathic
remedies, then reoccurred and she took a five day course of antibiotics (I
had recommended ten days but because the pain and lump improved, she opted
to stop after five days). From the time the lump appeared, she experienced
difficulty in latching the baby to that breast again and was able to pump
only very minimal amounts of milk. She continued to feed from the R breast.
I did not see her but gathered from her that the situation had resolved.

When I later phoned to find out how things were going, I discovered that she
had just been admitted to hospital for I & D of a breast abscess (major
guilt trip, here). I spoke to her the day after surgery and the surgeon had
given her meds to "dry up her milk" and her breasts were bound. She was very
emotional, in pain and missing her baby dreadfully. I phoned again a day
later and discussed with her the option of continuing to feed from the R
breast, knowing how passionate she was about breastfeeding. Her breasts at
that stage were extremely painful - the R from the surgery and the L from
engorgement. She opted to stop the meds, unbind her breasts and express from
the R. She felt that if weaning was necessary, then it should be done at her
own pace and not abruptly.

I spoke to the nursing staff, who were surprised that the surgeon had
ordered the breast binding in the first place and then they assisted the mom
in pumping. I left repeated messages for the surgeon to contact me, which he
did not do until days later, when he expressed great anger at my
interference with his orders. I  sent him a letter and a 45 page document on
Mastitis and Breast Abscesses: (Mastitis, Causes and Mangement: WHO, Geneva
2000) which should still be available for downloading from the internet.

The mom was discharged home and resumed breastfeeding on the R breast only.
The L breast healed and never showed any signs of engorgement. There are
many more details to this story but I have tried to be as brief as possible.
Hope this helps you in some way, Nuala.

Rosemary Gauld.  RN, RM, IBCLC in a very hot (mid 30 degrees C), dry Cape
Town, South Africa where it rains in Winter.

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