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Infant feeding

Abscess Sufferers

162 replies

mariasmummy · 09/12/2009 16:06

Hello,

If anyone has experience with an abscess please post me your story. I am 2 weeks post op with a reasonably large wound and I think i am looking at 1-2 months of healing.I cannot breastfeed from the infected breast as hole is so close to nipple and a lot of leaking (either milk or pus or bodily fluids) doctors say don't feed from it, nurses and counselors say do and general asdvice is get the milk out. Most sane people would stop breastfeeding after this but I'm keen to see it through and am feeding baby fine from other breast with occasional top ups. Baby is fine but I wish I had taken care of myself and got to doctors earlier.

All the best,
Mariasmummy

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nicnac73 · 09/12/2009 19:14

H mariasmummy... I just noticed you started a new thread so I'll copy my posting from the other one:

I just got back from the hospital so forgive if a bit wobbly - just had sedation this time. Apparently I was talking all through the op but I don't remember anything - how bizarre. I had my 2nd op 2 weeks ago and since then it has healed really quickly but I am afraid yes it was 4 months ago and its still not over. Today they sewed the hole up and hopefully this will mean no more daily packing and might look better but hey, my glamour modelling days are over (wink) and its on the side so only my nearest and dearest will see it. Undoubtedly this time it has been easier because there wasn't the complication of the milk.

Breast feeding is so emotive and political that this situation is a real test of your own instincts. I was told by NCT counsellor that I could carry on breast feeding through this awful time. When you are in this situation you are so vulnerable (not to mention all those hormones raging) but now with the benefit of hindsight I can't believe the so called 'advice' I was given always conflicting. How did the NCT telephone counsellor know what bug had infected me!!!? She had hardly done a biopsy!! One doctor told me it could be an E.coli that had got in there!! The point is all science seems to go out of the window. Looking back I can't believe I was not advised to stop breast feeding and I was told it was 'my choice' so of course I felt really guilty. Every abscess is different. Some people who obviously receive prompt treatment and damage is limited manage to carry on however, it depends on your particular circumstance. I wish the medical profession could give better more objective and scientific advice but unfortunately they let us Mums carry the burden of all the guilt. My wound was massive and weeped blood, exudate and milk for weeks on end. I couldn't go out of the house as the dressing would leek after 4 hours. I actually took tablets to sway the milk away called cabergoline and that was very traumatic as well. They weren't that effective though and the pain of engorgement on top of the wound was excruciating for about 2-3 days but lets face it its all bloody painful. My milk even came back a a little bit after about 2 weeks

I felt I really had no option to bottle feed which I really don't regret and as time passes I feel more proud of myself for making the decision that everyone else was too scared to help me with. The pain of engorgement with an open wound was awful but it just didn't make logical, scientific sense to me that I would be able to heal from an open would if the milk ducts were exposed to the extent that they were. Also, my baby had dropped from the 65th centile for weight to the 9th by 5 weeks old. He was an emaciated little waif with stick arms and legs and sunken grey skin. I can't bare to look at the photos of him them. The breast feeding 'enthusiasts' were still telling me to carry on (and thus making me feel guilty)!! My maternal instinct and logic won out over all the guilt and I gave him a bottle and he was never happier and I can't imagine how much worse my own situation would have been if I had tried to battle on.

Also, I had been seperated from my baby in the hospital as I was put on a general ward for 24 hours and had spent loads of time before that going from one hospital to another so my milk supply had dwindled and obviously I struggled to get a letdown. I took my own breast pump to the hospital and the last time I used it was before the op to ease the engorgment and I got 10ml. The doctors on that ward were next to useless. I should have been on a maternity ward with my baby and then I might have had a chance, not a mixed ward with a loads of dirty old men listening in and useless junior doctors unfamiliar with how breast feeding works. We are mammals for goodness sake, don't they learn about this in medical school!

Every situation is different but I am proud of the decision I had to make and it is probably the most grown up and adult thing I have every had to do because nobody in the medical profession will do the kind thing and help you make the decision they just hide behind their political agenda or ignorance.

In terms of your healing Mariasmummy...I had the district nurses come for ages - about 12 weeks and they were great but unfortunately it didn't heal properly and left a 'track' inside which was revealed by the ultrasound I had at the private hospital. I found it too painful for them to pack it with gauze at the beginning so they were packing it with a gel, I suspect that that may have meant that it wasn't getting into all the crevices of a wound and collections were allowed to remain but I am only theorising. Towards the end of the 12 weeks it appeared to healing up and scarring over and then would start oozing again ( I now know this was because of the track.) it did actually heal over and I went back to work p/t and the day after it burst again and that's when I went to see the private consultant as I couldn't go back to the NHS hospital again it was so traumatic - far worse than my 28 hour labour followed by a emergency C-section.

If you are able to carry on breast feeding Mariasmummy through this then I take my hat off to you and you should probably get an award from Mumsnet or something.

I think lexilicious had a similar bad abscess is this right and did manage to carry on breast feeding ?

Sorry for long post - hope is useful

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christiana · 09/12/2009 19:19

Message withdrawn

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nicnac73 · 09/12/2009 19:52

The thing about abscesses is its so difficult to generalise. have the nurses and counsellors that are advising you to continue feeding seen your wound?

Mariasmummy
have you had the pathology report back on what bacteria you had in there and has it been swabbed again so that you know it is clear? Remember you are always at risk of re-infection with an open wound.

Kate Garraway from GMTV had a an abscess this year. GMTV aren't exactly renowned for going into too much detail but she did have two ops and did continue to breast feed. A friend of mine had it too and she has the tiniest puncture wound and managed to carry on. Mine was massive. Although it was very deep, when they got it out it was 3.5x3.5 cm cavity wound but as the pus came up to the surface it had spread laterally as well between the layers of the skin about 10cm diam circle. It looked like runny butter under clingfilm and afterwards it was red raw on the surface where the skin had peeled away, that was one of the worst bits,

Beware the general advice. Everyone should be able to see a breast specialist consultant who should advise on their specific case.

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mariasmummy · 09/12/2009 21:45

Wow Ninac I cannot believe your experience. I am so sorry the pain! AH. I am aware of re-infection and this is scary. I know the nurses have been packing the wound well and I know enough about abscesses to know this is important. It has closed 2 mm in 8 days. I am going to breast clinic at hospitl next week although i would like daily visits with them for reassurance.

Its amazing what women go through. I am able to feed baby from other breast easily so it seems easier to feed from there. I mean easier in terms of literally sitting in bed -healing- feeding from easy breast. But i keep asking doctors if i continue to feed will it hinder the healing beacuse i am very serious aout getting better and I would not want to compromise my own health at this point in order to carry on bf. No one has said carrying on with one breast will hinder my healing.

Lets stick together! I am scared to be alone and my mum and mother in law need to be here every day and my husband i need to be around constantly. Its fear of infection and fear of being a new mum, i have low confidence...

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mariasmummy · 09/12/2009 21:52

Sorry Ninac, hospital did say they would send off sample but have not heard back about that will ask next week.

Oh i really hope I don't need two ops! But am ready for it. I just hope the packing is wokring nurses say wound looks clean. Having packing done at surgery tomorow and seeing GP as well.

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weasle · 09/12/2009 22:18

mariasmummy and nicnac sorry to hear of your problems.

in my experience, the vast majority of doctors, including specialist breast surgeons, will say not to feed for ANY problems,as they no nothing about breastfeeding. Is it too painful/difficult to latch the baby on due to the site of the wound?

all wounds and all skin will have bacteria growing on it, so a swab may never be clear, and in the absence of further infection swab result will not be helpful anyway. if the nurses say the wound is clean and healing that that is very good and reassuring and a swab is not needed.

i hope it heals quickly and well done managing to continue to feed, i hope you can continue to do whatever you feel happy with.

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Reesie · 09/12/2009 22:30

I had a breast abscess follwing my first baby - aren't they joyful? I haven't had time to read all the other posts but thought I'd let you know what happened to me.

Anyway - I saw a fab consultant breast surgeon who encouraged me to breastfeed and stated that as long as my milk wasn't blood stained at all then it would be ok to feed off the affected breast.

Importantly - you MUST pay attention to you latch - incorrect attachment of baby to the breast can cause problems with equal milk drainage around the breast. Get seen by a specialist breast feeding midwife. Your nipple should be the same shape coming out after a feed as it does going in. In retrospect I can now see that my attachmnet was appalling!

I carried on breastfeeding for 15 months. DD2 is now 7 months and I haven't had any other problems (except a couple of bouts of mastitis). I'm just in the middle of reading politics of breastfeeding - so will probably BF for a the next couple of years!

Well done for carrying on with the feeding

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Lexilicious · 09/12/2009 23:12

Hi, I've written about the timescale of my mastitis and abscess originally and recently here so I won't repeat that, but concerning whether or not to feed from the breast, here's what I thought:

The mastitis is caused by a blocked duct - if I don't keep milk flowing the blockage simply can't shift. (DS 6 wks)

OK, it doesn't want to shift and I'm on ABs that the doc warned might taste nasty in the milk and DS (8wks) might reject me (sniff). But he isn't rejecting, so I'll keep going.

The affected bit, once it had become infected/inflamed and was showing a 2cm diameter yellowish 'head', has gungy horrid milk/pus in there. But that's only one or two of many ducts - the ones still getting to the nipple are producing good milk so let's use it. (9wks)

Lab test on pus/milk came back blank - culture hadn't grown anything. So the infection is over and all that is going on now is the physical injury to the breast tissue (and the healing process). So I'll keep going.

Then about 4 weeks of waiting for the wound to close (5mm across at its worst but quite deep. I'll just soak away the stuff coming out of the side of the boob and keep using good stuff from other ducts coming down to the nipple.

14 wks - it's closed up but still a bit tender and a firm lump under the surface.

Now I have a scar and am still exclusively bf-ing DS at nearly 19 weeks.

OK, for a limited time only I am going to put a picture of the erupted boob on my profile... (weird, TMI, but I hope it helps?)

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lucasmama08 · 10/12/2009 12:19

I had a large breast abscess that ruptured by itself leaving a fistula (too lazy to type in the details, but i did post about it in reply to this thread and also a little here if you're interested)

Mine healed completely in 6 weeks but only after I stopped pumping (from both sides). It then healed up very quickly. However, I think the fact that it drained via a fistula rather than a surgical incision might have speeded the healing process - not that I would recommend it to anyone!!!

It took my consultant to impatiently snap "we're trying to save your breast" at me (in response to me being reluctant to stop pumping) to get me to give up my dream of bf-ing. In hindsight I am happy with my decision, although it was hard at the time. It also gave me the time I needed to rest and recuperate.

I am definitely not recommending you give up on bf-ing, although I do agree with nicnac73 in that you should get a special MN award if you do manage to continue!!!

Hope you feel better soon

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Lexilicious · 10/12/2009 12:47

fistula, that's the word.

I agree with lucasamama that bf-ing may prolong the time that the wound site is active. I was conscious of this but I saw it as flushing out the problem. As long as you keep the wound clean it shouldn't introduce any new problems.

But if your priority is speedy healing then perhaps ceasing pumping/feeding once the infection has been flushed out is the right thing to do. The breasts work reasonably independently so you could continue on the other side. I think?

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nicnac73 · 10/12/2009 14:05

The 2 breast surgeons I finally saw were fantastic. They did know a lot about breast feeding and were very objective. Perhaps because they deal with mending damaged breasts they err on the side of caution with regard to feeding however the non-specialists I found to be dangerously incompetent on the whole.

Unfortunately, I saw a specialist too late and in the absence of any professional advice I made my own decision although they did agree after the fact that stopping feeding would aid recovery in my particular case.

I would recommend Mariasmummy to listen to the specialists as they know your particular wound. Some abscesses can be the size of a pea and some practically take over your entire breast. Some people end up with a puncture wound, a narrow fistula or a gaping open crater.

The medics and all HCPs can only tell you what may or may not aid your recovery anyway as medicine is not the precise science people think it is. They just deal in probabilities.

I found this a huge test of instinct.

Can anyone tell us how feeding off one breast might effect the other? Does the prolactin produced in the brain tell both breasts to produce milk?

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mariasmummy · 10/12/2009 14:23

interesting to hear stories thank you. lucasmama how old was your baby when you stopped breastfeeding/abscess?

mine is only 6 weeks so i just feel sad about stopping but just today gp gas suggested stopping to help with healing process.

good to hear your healing was 6 weeks my nurses have said i could be that long so i hope.

can i bare the guilt of stopping bf???????!!! i so wish someone would just tell me what to do! I am going to hospital for check up next week and will discuss whether continuing to feed from one side is affecting the flow of milk and the healing process.

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mumblecrumble · 10/12/2009 14:27

Hello, not had an abcees but fed almost exclusively for 6 months on one breast then fed on one breast till DD was 18 months. Only stopped to hours at work.

Feeding from one breast is perfectly possible (if you find you need to). My supply in non feeding breast obviously reduced and after a few weeks didn;t leak or feel too full. However my feeding breast was able to supply all DD needed.

Finished feeding about 8 months ago and both breasts have teeny droplets of milk so obviously neither have dried completely.

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lucasmama08 · 10/12/2009 20:17

mariasmummy - DS had just 3 weeks of bm; 5 days exclusive bfing (before he got badly dehydrated) and the rest a combination of bm, ebm and formula. At 3 weeks I had to switch to a non-bfing compatible 'macro-antibiotic' and so pumped and dumped for over 2 more months to keep my supply going in the hope I could resume bfing later.

I have huge regrets over my bfing experience with DS - I regret not properly educating myself about bfing before DS was born, I regret letting him get so poorly before giving formula/ebm and I regret not being more assertive about our latch struggles. However, I do not regret giving up on bfing when I did - it was the right decision for both of us at that time.

I am not suggesting that giving up is the right thing for you to do, unfortunately that's a decision that only you (and your family) can make. I'm just trying to say that if after all your hard thought, that is the decision you come to then it is probably the right decision for you and you probably will not regret it.

mumblecrumble - I was told (possibly incorrectly) that I needed to stop doing anything that would stimulate my milk supply, including pumping from the unaffected side. Mind you, I was never given any evidence/information to back up this assertion.

nicnac73 - I have just read your experience on this post . This is very, very similar to what happened to me - I was under GP 'care' for over 5 weeks before I got a diagnosis (during which time I saw a GP at least twice a week). I was told I was 'too well' and not in enough pain for it to be an abscess. I repeatedly asked how I'd know if it had turned to an abscess and was given answers along the lines of 'believe me, you'll know'. I only got a diagnosis after I went to A&E and got a next day ultrasound appointment which confirmed I had the largest breast abscess the sonographer had ever seen (she took some convincing that it wasn't a breast implant). It ruptured itself that night before it could be operated on, although by that stage I do believe that was the best thing that could have happened as it meant a relatively quick recovery and no packing of the wound. I had thought that my case was a one-off and, like you, let it go. I am shocked to hear that is not the case

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ilikemrclooney · 10/12/2009 21:57

I recently had what in retrospect was deffinately an abscess, as it was exactly as Nicnac73 described in her post. I had previously had mastitis which was horrible, constantly painfull and then quite soon afterwards got an abscess, this was less painfull, didn't perticually hurt when i fed, only when DD caught the sore bit with her fingers as she scrabbled about. That hurt a lot. I saw the GP, (a male locum one, forgot to request the great female doc when i booked appointment and then receptionist flatly refused to swop me over when i got there) he diagnosed celulitis (Spelling?) and prescribed 10 days antibiotics. The next day it ruptured in the shower which deffinately lessoned the trauma of this greatly, lots of yukky stuff came out and it left a small round hole. It took a while to get better totally but was much less sore straight away and i carried on feeding with no problems.

Having read this thread i feel that;

a) I should have told the doc that i thought it was an abscess rather than just wandering out feeling confused.

and b) I got away very lightly.

Crap that he didn't diagnose it though, although i suppose the anti biotics would have been the same treatment anyway.

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nicnac73 · 11/12/2009 08:40

So sorry to hear that my case was not unique. It is a scandal that we get fobbed off so badly for something that could actually destroy our breasts.

Both my male GP who initially refused me antibiotics and the stupid registrar at Heartlands Hosp. (who I know has since been sacked so at least that is some comfort) both recomended that I should wear a bra and in the case of the GP; carry on massaging etc etc, and the Registrar to carry on taking the same ABs that hadn't worked for a week. If a man had a swollen red patch half the size of his testicles do you think he would be told to just wear some tight pants and go away and hope it gets better???

I was massively engorged and had one breast noticeably bigger than the other. My nursing bra purchased at the 37th week of PG was too small at that point so I did question whether they really meant that I should put a compress on it!! Idiots!

What is really frustrating is that this can't be about funding. It would surely have been cheaper for NHS for me to have ABs in the first place (impossible to kow if they may have worked at that stage, 5 days into mastitis, but prob worth a try?). It would have been cheaper to do ultrasound and aspirate with a needle than general anaesthetic and all the costs of theatre not to mention cost of the district nurses who came everyday for 12 weeks. Its just about ignorance and incompetence in the system.

I too wish I had reacted differently, been more assertive, but when its happening to you and with the hormones and lack of sleep and you are being told everything is alright by doctors...hindsight is a wonderful thing but we are the patients. its never happened to us before, how can we know what to expect or what to ask for. Its the professionals who should know better. Nobody should feel regret. ilikemrclooney (me too) why do you think you should have told the doctor that it was an abscess. Its not our responsibility to diagnose ourselves.

We should really do something collectively about this. For a start there is no advice on MN about what to do if you suspect that you have an abscess. I also feel strongly that all should have prompt access to ultrasound and there should be guidelines on what antibiotics to prescribe and when for mastitis.

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mariasmummy · 11/12/2009 10:53

Yes. What shall we do? I am so upset and angry that just because we are women and have babies that we should have to put up with problems such as these. If i had been given more information when i was pregnant abscess could have been avoided.

I would have known to pump so much more at the beginning when the milk comes in.

There is certainly not enough help for women regarding breastfeeding and not enough resources regarding breast abscess.

Wound still leaking...still feeding from one breast u til hospital next week. My GP wanders if I should take pills to stop lactating- stop bf to speed up healing. I am deciding whether to stop bf next week. Its devastating because I love it and it works perfectly from unaffected side. Seriously hardwork

Well done everyone for getting through your experiences.

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nicnac73 · 11/12/2009 12:17

I am going to write an email to MN contact us to ask them to give better advice on their pages for Mum's who suspect they may have an abscess.

I think they should advise
-prompt action
-insist on an ultrasound and biopsy of the infection.
-advise what to expect i.e. needle aspiration or could mean GA and theatre.
-What healing might be like.
-Options for feeding afterwards with the recommendation to seek professional advise specific to your case.
-Insist on being put on a maternity ward. NHS should not seperate mothers who are breast feeding from their babies.

I don't know what MN could do to petition the RCM or BMA for better awareness amongst doctors and HCPs for mastitis and abscesses and all the above should be standard.

Lets all send emails to MN

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nicnac73 · 11/12/2009 12:25

Mariasmummy

How sad and cruel and ironic it is that you have one perfectly working breast and one with 'boob blight'.

You want loads of milk in one breast and none in the other really.

I don't know how to link to another thread because not very techno (same mobile phone since 2003 - sad case I am) but you may find the recent thread from Christiana ' Help can you have an injection to stop the milk?' useful if you are advised/do decide to take the tablets.

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nicnac73 · 11/12/2009 17:42

Think I've cracked how to insert the linkhere it is

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joyjac · 11/12/2009 18:02

If you cease nursing on one breast the milk will gradually dry up. If you continue to nurse on the other breast, it will eventually step up production to meet your baby's needs. it is the stimulation of the baby nursing that keeps the milk supply primed.
Incidentally, milk coming out through the wound is sterile and just flushing out. Mine was not as severe as some of you have had and although near the areola I was able to continue feeding on that side, although I was exceedingly careful of the area for months.

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nicnac73 · 11/12/2009 18:39

It is so good to hear of stories where you managed to keep on breast feeding. I am very sad I couldn't manage this . Best of luck with this Mariasmummy. We are all rooting for you.

Good news. I contacted MN and they are going to research into the topic and put some advice on their pages.

They also suggested I post on the campaigns thread so I started a Save Our Boobs campaign here'sthe link

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mariasmummy · 12/12/2009 16:08

Ninac brilliant well done. Thanks for the support! Spoke with nurse specialist at hospital yesterday (post GP suggesting I stop lactating) and she said no way that has to happen. Keep going on the one breast, express with the infected one and leaking is normal. Nurse still come once a day (possibly twice) and just waiting and trying to be patient regarding healing. It will be at least a 2 month process in my case... I wander if the nurse will come on christmas day? GOing to be an interesting one. We were so looking forward to baby's first christmas. But i realise how lucky i am. Could be a worse scenario regarding the breast.

Best wishes everyone

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nicnac73 · 13/12/2009 12:26

I guess ours is a minority issue or a bit too gory as no responses whatsover to the campaign threads SAVE OUR BOOBS! Boo hoo. Nevermind, perhaps we aren't going to be able to change the world or the Health Service but I suppose at least MN are looking into updating their info and we can be here to give each other some support.

It is wonderful that the nurse specialist at your hospital said that she believes you can carry on bfing. You are very brave Mariasmummy as I know how difficult that this situation is. I wish I had been able to do this but other boob was working very well either and DS was really underweight and no help or advice at the time as you know. I think this experience made be quite bitter about bfing but since joining MN and hearing so many positive experiences I have softened a bit.

I think the District Nurse's will come on Christmas day if you still need everyday visits by then. I can't remember at which point I stopped needing daily visits and they started coming every other day but you may be able to skip a day by then if you just wanted to be left alone from all the prodding.

What kind of dressings are they using? I got fed up of Meplex as they got really soaking and not very adhesive and kept falling off. I had these oval one's called Tegaderm for quite some time and they were a better fit. Not surprising really, putting a square patch on a round boob was quite problematic. All of them irritated my skin after a while though. Can't believe I've had some kind of a plaster stuck to my boob since August. The one that the Doc put on after my Op last week is non-water proof and he's not taking it off till next Friday so really struggling to keep it dry and keep self clean and non-smelly. Can't wait to have normal boobs again even if they do have a battle scar. DH says that this and horizontal stripe from C section and vertical stripes from stretch marks are all badges of motherhood.

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mariasmummy · 14/12/2009 19:28

hisorry so tired and baby still up most of night. I have sorbsan? I think- for the packing and adhesive absorbing dressings. THey work just about and I prop up with tisues when leaking bad. I thought was drying up but today nurse went in and really prodded around to clean it and it started bleeding!

It is so depressing now. I keep crying and now more painful I wander if thats the tissue forming again. I so hope by christmas will be drier and less dressings but who knows?!

Regarding the bf, i know i seem strong but i find whipping out a boob to feed much easier than all the sterilising stuff and so on. Even if she feeds for 10 mins or so, its not like am out and about. However am going to ask hospital again on weds, if i stop bf will it heal quicker? If answer is a resounding YES then will stop. Its too much. I can go day by day but if i have to look months ahead then I'll stop.

What would be good is if MN can get something on the bf link regarding abscess. There is nothing! Most things go so far as mastitis only, so strange not to mention it if i had known i would have expressed like no tomorow and hit the doctors much sooner. EVeryone needs to know what could happen. Or are we just that unlucky?

I think you have been amazing what youve' been through. How is your baby? How is the rest of your life in relation to the past few months?

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