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Biopsy while breastfeeding

(11 Posts)
countrylover Wed 10-Jun-09 14:57:00

I found a lump last week and because I didn't have any other symptoms of a blocked duct or mastitis ie painful lump, fever etc I was sent for a biopsy.

Thankfully everything is fine and it turns out it was just a blocked duct. However the site of the biopsy is leaking milk and I don't mean a little bit. Enough to require a breast pad to be attached to my boob all the time. I wouldn't mind but I have to change it every couple of hours and it sticks out of top of my t-shirts so people keep asking why I'm wearing a bandage at the top of my boob.

Obviously the wound can't heal because the milk keeps on coming. My GP was useless and suggested giving up breastfeeding to allow the hole to close over! I'm going back to the consultant at the end of the week but in the mean time has anyone had experience of this?

Jennylee Wed 10-Jun-09 15:59:08

its called a milk fistula, I searched but found only this discussion, hope someone else knows what to do

Jennylee Wed 10-Jun-09 16:07:23

this is off the site the lady got advice from jack newman

a story off that site

Biopsy was performed 7/21. Leaking noted within a day. I used Lansinoh disposable pads to collect the milk, and I was going through 2-3 a day. On 7/31, I returned to the surgeon for a follow-up, and he taught me to apply a pressure dressing on the basis that keeping the pressure in the ducts low would allow the incision to close up and heal. He also recommended a breast binder, which I was not able to find, nor was I convinced it was a good thing to use anyway.

I spoke with a LC who recommended that I nurse more on the fistula side to keep the pressure low. After a week of doing that, I went from leaking out of one part of the incision to leaking out of THREE. I emailed Jack Newman for advice, and he said to wean off the fistula side. I was really disappointed because I felt like emailing him was the magic bullet, and it was the last thing I wanted to do. However, I had a terrible allergic reaction to the surgical tape, so I was pleased to stop doing the pressure dressing.

It took about a week for my supply to adjust enough that I could get away with only nursing a couple of times a day on the fistula side. (We nurse at least every two hours when we're together--I work out of the home four days a week--so twice a day on the fistula side really isn't much.) Within the next week, the leaking had stopped. Two days later, I saw a wound specialist who said that it was healing nicely and would be fully knit together all the way through within a month. We just hit the 30-day mark, and yesterday, I started to nurse her again as much as possible on that side.

Things of note:

* I am currently lopsided. It's an aesthetic thing, but it's noticeable to me and to my partner. I used a breast pad on the fistula side even after I wasn't often leaking because it gave me a little extra boob girth.

* I had a lot of trouble pumping enough milk for her when I was away from her. I started a rigorous pumping routine (which I can say more about if anyone is interested) and pumped from the fistula side once a day and nursed on that side once a day.

* For whatever reason, nursing on the fistula side made her a little spitty in the last week or so. The milk pumped from that side did not, but it was always mixed with non-fistula-side milk.

* I work for a large medical system, and I do patient research. I am very skilled at navigating a medical system, and I really feel like my case was mismanaged, even when I advocated for myself so strongly. It's very easy to get lost, but you don't have to. You can stand up for yourself and get the care you need. If they won't give it to you, you can take matters into your own hands. Let me know if I can help in any way.


countrylover Wed 10-Jun-09 17:35:16

thanks jennylee - it doesn't seem like there's a quick fix to this does there?

oh well, guess it's worth it to be able to carry on breastfeeding.

Jennylee Wed 10-Jun-09 17:42:05

hope you get through it , sounds really difficult and like the last thing anyone needs. breastfeeding can be challenging enough without this sort of thing. Hope you get through it okay.

BelleSeuss Thu 11-Jun-09 08:56:17

Hi countrylover - I had the same problem last winter - they didn't warn me milk would start coming out of the hole, so freaked me out! It mainly leaked at let down.

How long ago was the biopsy? One hole healed easily - this had the sides opposed as it was under my breast. the one on the top was gaping, and this took a week to heal. I ended up using alot of tape to haul my boob up so the edges opposed, then changed the pad immediately over it regularly. It DID heal! Milk is full of white blood cells etc so if you keep the area clean, it will hopefully heal without becoming a fistula.

My boob was really sore, so I took paracetamol to ease the inflammation and pain, and kept feeding on that size to reduce pressure - if you stop feeding that side your boob will become enlarge, sore and make the hole gape even more.

Contact the hospital for advice - my consultant said that they use to cut holes in the breast to drain abcesses etc and not tgo worry - it will heal.

Hope you get positive results - its a nerve racking time

BelleSeuss Thu 11-Jun-09 09:02:29

forgot to say - your baby may posset more if there is blood in the milk, this should stop after a couple of days though.

oh the joys of the breast feeding mum!!

Jackstini Thu 11-Jun-09 09:39:31

CL - I had an breast abcess burst earlier this year and managed to keep on feeding. We had to use some funny positions and keep a dressing on for a while; also had ibuprofen to keep the sweling down for a couple of weeks. However, it healed fine and am still bfing 4 months later. Good luck smile

countrylover Thu 11-Jun-09 10:08:04

This all sounds much more positive - I was so upset last night thinking that I'd have to give up breastfeeding so early as DS is only six weeks old. {sad]

I had the biopsy a week ago but the hole doesn't show any signs of healing over.

It only leaks just before I'm due to feed and at let down but obviously this happens every six hours or so (I feed from alternate boobs for each feed) so there's not time for it to heal over. My consultant said to try and keep the breast empty for two to three days but how the hell am I supposed to do that?!

I guess I need to leave it for a bit longer to see if it will heal on it's own. Honestly, it's one thing after another with me. sad

BelleSeuss Thu 11-Jun-09 10:20:39

I kept feeding as much as I could from the problem boob (both had lumps that were benign), then offering the other side.

try expressing the other side too to keep up supply, and try different latches to help with the pain.

I was also at the 6-8week stage and scared I would have to stop - now at 7mths we are weaning after exclusively BF - it is possible!

( if you stop feeding your boobs will be engorged and at mastitis risk,and even more sore, so stopping is not an easy option, which is why I tried to battle on, despite being an emotional wreck at the time fighting off pnd - you can do it!)

countrylover Wed 15-Jul-09 11:17:56

I just wanted to post on here again so that anyone else facing this problem in the future can get some more information if they're doing a search on Mumsnet.

The hole did eventually close over after around two weeks, just when I was giving up hope. I am still breastfeeding now so don't believe any rubbish GP who tells you to give up!

I managed to get the hole to close over by following the advice above. I fed as much as possible from the problem boob to keep it as empty as possible.


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