Breast Abscess hell! Want to quit bf. Help!

[BeachMum85]

Dd is 4 months old. Having struggled with bf from day1 I developed what I now know to be mastitis that turned into a "huge lactational breast abscess", thanks to multiple misdiagnoses and seeing 4 different GPs, 2 midwives (after turning up at the birth centre out of desperation and being told I had a blocked milk duct that needed to be massaged out (!)), 2 health visitors, 1 "lactation consultant", 1 general surgeon (in the middle of the night at the weekend after being admitted to hosp for IV antibiotics, only to be sent away with oral antibios as they couldn't accommodate dd), and finally my saviour 1 breast consultant (a prof) who finally diagnosed abscess after 3 weeks of excruciating pain, swelling, redness, several courses of antibios (cefalexin & metronidazole) and not being able to hold dd except to bf :(

So now, after 3 intensely painful ultrasound-guided needle aspirations over several more weeks, I have noticed a lump and some redness still existing, which I fear may be the 'bioma' that the consultant warned me about - ie a collection of sterile pus. Has anybody out there had this? How was it resolved? Through more aspirations? I am terrified of surgery or the abscess infection reoccurring!

On top of this I desperately want to give up bf! I am not seeing the consultant for 3 more weeks, and he advised t carry on bf to keep the milk flowing, but I am miserable! Bf has always been painful for me and although it was a really tough decision, I need to move on as I can't help feeling happy mummy = happy baby?? But no one can seem to advise me about weaning! Any help/experience out there greatly appreciated!

[StillSlightlyCrumpled]

I wish I had some advice for you, but although I had numerous bouts of mastitis & an abscess mine did get resolved reasonably quickly. It did end breastfeeding for me though.

I just wanted to say massive well done for persevering for this long. You've done brilliantly. Hopefully someone with real knowledge will be along shortly.

[mummymog]

again i have no solid advise but comiseration, and /i agree with you happy mummy = happy baby. The benefits of breastfeeding are outweighed if its causing stress. You're doing great. :)

[BeachMum85]

StillSlightlyCrumpled thank you so much. Was your abscess resolved through needle aspiration? We're you left with any lump/ scar at the end of it? Also how soon after did you wean and how? Sorry so many qs!!!

Thank you mummymog for the support!

[TheUnstoppableWindmill]

You've done amazingly well. I had misdiagnosis too but luckily only for a few weeks, and it didn't get too bad, but it infuriates me that blocked duct is always the immediate assumption (what? Massage the swollen lump of infection in my breast? What good advice!) I fume about the fact that while I had TWO antenatal classes on BFing no-one ever mentioned any of this!
It took a few weeks after the final aspiration (I just had 2- they really hurt don't they?!) for all of the hardness to disappear (2/3rds of my boob went rock hard- I think it's called 'caked breast' on kellymom). My consultant said to allow up to 6 weeks for it to return to normal. I think it was completely fine after about 4.
You've been heroic in continuing to feed and have given your daughter a fantastic start. It sounds like time to move on. I did continue to BF but it was never that painful to do so for me.
Whether I'd worry about bioma would depend on whether it's more than say 3 weeks after your last aspiration. Actually, as you're seeing the consultant again in 3 weeks I really wouldn't worry at all as the reason from this gap in time is to give your body time to finish off the healing.
As for giving up BF right now, I would be concerned about mastitis relapse. If you can keep going until you see the consultant again that probably is safest, and it is likely to get easier and less painful as you heal more. But I totally understand that you're desperate to stop, so is there any way you could phone your consultant's secretary and see if you could speak to them on the phone for some advice?
Very very well done, and good luck!

[BeachMum85]

TheUnstoppableWindmill thank you. I am shocked at the lack of knowledge about the subject, when it is in fact relatively common I now realise! Especially unforgivable in midwives and "lactation experts" who by definition are experts in all thins breastfeeding-related - to not be able to spot the early signs of mastitis ( I was fobbed off with the old non-infected mastitis story. The consultant then confirmed for me that I was n

[BeachMum85]

(Oops I clicked on 'post msg' mid-rant!)

... Not prescribed the right antibios at the correct dose early enough, or an abscess could have been prevented :( oh what I would give to go back in time and insist.

The main problem is that midwives/health visitors don't know enough about mastitis or abscesses (unbelievably) and surgeons don't know enough about breastfeeding, so it feels like a vicious cycle with me in the middle piecing it all together.

Thank you for your advice re: feeding and the bioma. It has been about 6 weeks since the last aspiration (they drained 350ml over 3 asps) and it has gone down significantly but there is still a small patch of redness and a hard mass underneath that is a bit sore, but no flare-ups (thank goodness!). Trouble is my consultant is away for a few weeks apparently and I am loathed to deal with someone else who will give me completely conflicting advice and methods again.

[RobinVanPrissy]

You poor thing.

I had this after having both my babies - seemingly neverending mastitis and a horrible abcess. Saw loads of people - MWs, HVs, my GP, various BF 'experts', A&E numerous times etc. It was hideous.

With my first baby, I was given all the usuall twaddle about cabbage leaves and massaging the breast, when in retrospect I should have been given antibiotics. I was very unwell - flu symptoms, high temp and agonising pain at every feed. I was producing milk that was bright pink, probably about 30% blood. Nobody seemed to take it seriously at all and I found every professional I came in to contact with, bar the A&E doctor, patronising and useless. It marred my whole first time experience of motherhood, to be honest. Eventually, I had it drained twice, stopped breastfeeding and it went away, although for months my breast was still red and a bit angry looking.

Second time round I knew the symptoms a soon as they started and took myself off to A&E where they drained it. Midwives were encouraging me to keep feeding, but I couldnt bear the thought of weeks and weeks of misery and pain, so stopped. It healed much more quickly that time.

I dint think you need to take advice on whether to continue feeding or not. I wiuld never take bf-ing advice again on this matter. If you want to stop, stop. Nobody understands how painful and horriific severe mastitis and abcesses are unless they have been through it themselves.

[TobyLerone]

I had an abscess after 2 bouts of mastitis when DS was 3 months old. I had to have it drained under GA, despite me begging them to do it under local.

It was awful and it ended breastfeeding for me. I never felt guilty, though. It couldn't be helped and I really did my best. So have you, OP.

[BeachMum85]

RobinVanPrissy that's awful! You poor thing. It's so good to hear from people who have been through this hell! Can I ask, how did you give up bf? Did you just start dropping feeds gradually?

TobyLerone poor poor you! I am worried that I may have to have GA to remove the bioma if that's what it is :(

[TheUnstoppableWindmill]

Sounds like I had an easier time of it than some!
If you can drop feeds gradually that's probably the way to go, and if others found that the healed faster by stopping feeding then that may well be the right decision.
I'm so sorry the consultant is away. 6 weeks was the timescale I was given but I'm sure it can vary. Hope things work out and that you recover without further intervention.

[48th]

Poor you:( and unstoppable too. what a difficult experience.

Beach mum as your consultant has advised continuing you are better speaking to someone at the hospital before deciding what to do. There may be a specific reason why continuing to remove milk from the breast is helping your healing. You could do with checking this as well as doing everything to avoid milk stasis.

You could discuss stopping directly bf and instead express making sure you are using a good pump and have been shown how to use it to facilitate maximum drainage.

As for the lump I doubt anyone can tell you what the lump is as you would still often expect a lump at this point, it would be relatively unusual to have experienced good healing and then to need surgery.

I think you are right, you are the person in the middle but mws, ibclc s, GPS should all have correct info on mastitis/abscess and its treatment.

The info about mastitis usually being non infective is right though and self help usually resolves it fully BUT if self help doesn't make any immediate difference and or it has been going on for more than 24 hrs then a gp apt is urgently needed. The right ab and often given IV are then needed.

Unstoppable I think abscesses are rarely covered antenatally, they are pretty unusual as are a whole host of other bf situations that also rarely get a mention. I think it is just the pressure of getting the most generally relevant and useful info across in the given time.

Mastitis and abscesses need excellent gp/ hospital support. Anyone who thinks they have an abscess should be given an ultrasound, you can self refer to some units, get your gp to refer you or evn go via a and e.

Whilst weaning you might want to take lecithin, there is no research but a fair few anecdotal tales that suggest it can help some women. I also wonder if your baby has a tt or hick lip tie. Maybe there is something that could still be changed?

[48th]

Robin how awful too...how you were let down too:(

[RobinVanPrissy]

With my first baby, I dropped feeds gradually and was expressing for a while (hurt like hell but was quicker than feeding my baby, so the length of time I had to endure the pain was less).

With my second baby, I stopped completely and my milk dried up very quickly, about a fortnight or maybe less?

I had a huge supply of milk, too, both times. And a very violent letdown that choked my first baby. I am not sure what that means...

[BeachMum85]

Thanks 48th. I now know I had classic signs of infective mastitis, apart from flu-like symptoms, and despite numerous visits to GPs/ HVs/ MWs/etc I was fobbed off time after time with the old blocked duct/ non-infective mastitis story. I now know that a swollen, inflamed, red and sore boob should be aggressively treated with antibios, after like you say 24 hrs and sent for a scan, to avoid this hell. Mine was left for weeks with one GP even stating "well I can't feel an abscess" after having a prod and sending me away. We rely on the professionals to tell you what's wrong and treat you accordingly, not leave you to suffer, without a referral, until it gets so bad there is no doubt. The trouble was I had no idea what was wrong or where to turn next until I was finally sent for a scan and they aspirated there and then. Thanks for putting my mind at rest about the lump, it is hopefully just part of the healing process.

RobinVanPrissy thanks so much for letting me know. I have a good pump which has now become a very good friend :)

[48th]

I hope when you are better you complain if you can face it. Your treatment was awful and your outcomes could have been much worse than the awfulness you experienced. So glad you are on the mend.

[BeachMum85]

48th it's weird going over it all at this stage as you quickly forget the little details that have made it such a horrible experience. I want to quit bf-ing ASAP and cling on to that hope that the abscess continues to heal. Then I would really like to prevent someone else going through what I have and the treatment I received. Thx v much for the support.

[StillSlightlyCrumpled]

Beachmum, I didn't have such a trial as you but it certainly marred my early days with my son. He wasn't my first though and I decided to stop feeding relatively quickly. It's easy to underestimate how physically ill it makes you feel.

I just stopped actual feeding but expressed a lot. I also had thrush on my nipples so the actual act of having him latching on was bloody painful. I hand expressed loads and gradually reduced the amount / no of times. My understanding was that it was imperative not to get engorged. Do follow your consultants advice, though I remember sobbing in the car on the way home after being told to keep feeding till it had cleared. I honestly couldn't face it.

You have done amazingly & you should feel very proud that against the odds of rubbish care you've breastfed this long. You should have no reservations about stopping.

Btw once my milk had dried up so did the abscess, mastitis etc. blessed, blessed relief .

[FoxtrotOscarBackToEconomy]

BeachMum I just want to give you some support. I had an abscess that developed without temp and flu symptoms. Just a big lump and red patch. That I spent ages trying to massage out to no avail!

Fortunately it coincided with my check with consultant 7 weeks after c-section and she knew what it was straight away. I was sent for an ultrasound that day.

A couple of days later I had incision and drainage surgery under GA. I not going to pretend it was easy. I had an open wound that was packed by the nurse daily until it healed about 2 weeks later.

The dr recommended I stopped bf immediately and after surgery I couldn't contemplate anything but gentle hand expressing until my milk stopped. Poor 7 week old went from exclusive bf to exclusive formula on the day I was in hospital.

2.5 years later I have a barely visible scar and I very occasionally notice a discomfort, more so now I'm pregnant.

I understand how you are keen to stop bf. let us know how you get on. I found these threads very useful when I had my abscess.

[BeachMum85]

StillSlightlyCrumpled interesting that you managed to exclusively hand express, I have never managed that successfully (only when I was manhandled by the midwives on the postnatal ward which hurt like hell), but I do pump which helps (mainly at 4am coz LO sleeps 12hrs and I have to get rid of the milk). Sounds like you did the best thing by exclusively expressing and managing the situ that way, I hadn't thought of that.

FoxtrotOscar thank you so much for your story, they are all so encouraging to read. Interesting that you still feel some discomfort, I wonder if mine will ever go away. It healed partially very quickly then stopped and I am stuck with a red patch and still some soreness, especially when using or sleeping on my right side.

[jaybee78]

Apologies if i have put this post in the wrong area but as it was the most relevant and recently active I felt it would be appropriate.

First of all, may I empathize with all the mothers on mumsnet who have suffered with breast feeding problems, in particular with the development of abscesses which appear to be not managed as quickly and effectively as they should be by the GPs and community support.

Like BeachMum my wife presented with a large swelling to her left breast without a fever or temperature, the GP treated with antibiotics but failed to refer on to a specialist for diagnosis and instead continued to treat for mastitis. (by the time we were finally seen by a specialist the abscess was 12cmx12cm)

What I have learned over the past month is that the knowledge base within the PCT and community support is very limited and despite identifying issues in our management to the GP practice they do not see they have done any thing wrong.

With Breastfeeding in the news of late regarding paying new mothers to breastfeed it alarms me that there is not enough support available for mothers passionate for breastfeeding never mind those who receive financial incentive.

My wife ended up with an incision and drainage of her abscess 4 weeks ago, the abscess was found to be MRSA, (this was very emotionally difficult for my wife and I to cope with as our daughter had been feeding on the infected breast for 3 weeks) she was admitted for 7 days into the hospital with IV antibiotics and she had to stop feeding and put our daughter on formula. The breast surgeon told my wife it was the worst abscess he had seen in 10 years. We have had issues with the dressings as the cavity is filling up and leaking with milk requiring more frequent dressing changes as well as contaminating clothing and bedding.

We did originally have a VAC pump on as discussed in another thread but the wound care nurse felt the suction may be encouraging lactation. We are at the start of a long road to recovery, however this episode has driven me to want to improve standards and support both locally and nationally to improve support for breastfeeding mothers.

My wife looks back with regret as she enjoyed and wanted to continue breastfeeding.

[BeachMum85]

Jaybee78 this is truly awful, I have so much sympathy for you and your wife for the pain she must have been in. It seems so ludicrous that this is the story of so many of us mums, and yet is still regarded by the 'professionals' as "relatively rare" and therefore there is a dangerous lack of knowledge and care about abscesses amongst GPs/HVs/etc, until you finally get to the Consultant level. I join you in wanting there to be more training and more awareness of the symptoms and early diagnosis/treatment, as the sad thing about it all is that it can be prevented with the correct, early treatment. Well done to your OH, don't let her feel down or guilty about bf, she needs to be tip top for her LO.