Breast Abscess - filling with milk

[Emysmum26]

Hello - can anybody offer some help / advice on my situation.

following 2 bouts of mastitis I have a large abscess in my breast. My LO is 7 weeks old and EBF. The abscess has been aspirated by needle every other day for 2 weeks, the first 2 aspirations removed infection filled pus and blood (gross I know - I apologise!)The following aspirations have been mostly milk. The quantity has remained the same, my consultant says the abscess isnt healing as it is being held open by the milk filling it up. I have had 4 courses of antibiotics and so the initial infection has cleared.
4 days ago my consultant decided to try plan B as daily aspiration wasnt helping. He put in a drain that sucks out any fluid from the abscess the moment it accumulates thus keeping the cavity closed. The fluid drains into a bag so I can monitor the output - it has remained constant at around 60ml day. I am assuming from this that the situation is not getting better.
My consultant knows I am determined to continue feeding. I have been feeding from the one good side and pumping and dumping from the bad.
He feels that operating without stopping my supply would be dangerous as the milk enzymes could eat away at the open wound and cause even more problems.
I go back to see him on Wednesday to evaluate the drain and the progress over the week.
I don't know how long he will keep the drain in for - its really quite painful and a faff! The next step would be to operate.
It has been such a struggle to get to this point - i have felt really poorly and had alot of cluster feeding to get my supply in the good breast up to a level that keeps my very hungry daughter satisfied. She wont take a bottle and i have wasted my supply of frozen expressed milk trying to convince her.
Has anyone experience of this? Is it possible to take milk supressing drugs and then restart your supply?
It seems that nobody has all knowledge to answer my questions, my surgeon is a breast expert but not a breast feeding expert and my BF counselor knows nothing about abscess surgery.

I never thought it would be this hard!!!!

Please any advice would be really appreciated.

Louise xx

Oh Louise how painful and awful, I haven't got time to post right now butcwillget back to you later. In very brief... You don't need to stop bf to heal, the milk doesn't prevent this though some people prefer to. You can't take milk suppressing drugs then restart your supply, in fact even with drugs it could be a Long time before your breasts are milk free.

Abs often don't remove all the infection, have your courses been oral? Though the milk rather than pus is positive... Anyway will get back to you later must dash now.

Wow - that is just about the worst abscess case I have ever read about. What a terrible tale :(

48th is right - milk supply can't be turned on and off like a tap. It takes a while to be totally milk-free. I have to say - and bear in mind I know nothing about breast surgery - I have never heard that milk enzymes would prevent healing.

My experience with breast surgeons is that they are, on the whole, very deficient in their knowledge of breastfeeding (crazy, isn't it?). I think it might help if your surgeon did a bit of research, tracking down some literature and maybe speaking with surgeons who do know more about it.

Hope you get some answers soon.

OP I feel for you. It's sounds like you are having a very hard time and I admire your determination.

I haven't had an abcess, but I attended the breast clinic whilst Breastfeeding my DD as I had recurrent mastitis and a possibly ruptured breast implant. I have to say, they were worse than useless and not at all supportive of breastfeeding. As has been said, they surprisingly actually knew very little about breastfeeding.

It was extremely difficult to find anyone that knew about both Breastfeeding and breast surgery unfortunately, although the feeding advisor at my local hospital had some experience in this area. I also managed to find a private surgeon who was helpful. I think maybe an IBCLC may possibly be of help to you if you can find one in your area. It might also be worth asking on some of the Facebook pages that support Breastfeeding if anyone has experience in this area? Analytical Armadillo and This Milk Matters are pretty busy pages.

I'm sorry I can't be more positive or offer any advice on your actual problem, but I hope you can get it sorted out. One thought is what is the reason for pumping and dumping from the affected breast? As I understand it you can still feed from the affected side if its not too painful, but otherwise, would drying up that side only be an option? (Although this would take some time)

Louise have sent you a pm

Hi Louise

Your situation sounds very similar to what I'm going through at the moment.

I have been battling with abscesses in both breasts for over two months now. They initially appeared when my baby was two weeks old - I was treated with antibiotics and had to have an incision on one side to remove the fluid, with needle aspiration on the other side.

Within a couple of weeks the infection had cleared and all that was coming out was milk. I've been back to the breast clinic seven times now and the spaces just keep filling up with milk. It is really painful, so I've now started trying to find out if it would be better to give up breastfeeding. (I have continued to breastfeed from both sides throughout.)

The surgeons initially told me that there was no guarantee that the situation would resolve if I stopped, and I knew it would break my heart to stop feeding. However, the surgeon I saw on Friday said that the problem would continue for up to three months after I stop, because this is how long milk production continues. I had planned to continue exclusive breastfeeding for about six months and then feed before and after work, but I don't think I can handle this still happening when I'm back at work in February!

I went along to the breastfeeding clinic to see if the midwives had any experience with someone in a similar situation, but they said that most abscesses they'd seen had healed after one or two visits to the clinic. I'm struggling to understand why mine are filling back up every time, but I don't think anyone else understands why it happens either. The midwife gave me (very helpful) advice on positioning and attachment and encouraged me to ensure that the breast is emptied. But I think this advice is more relevant to blocked ducts, which isn't the issue here. I don't think that any amount of feeding or pumping will get the milk out of the space once it's there, and the more I feed, the more the milk leaks into it, I imagine.

I'm seeing the surgeon again on Friday and back at the breastfeeding clinic next week, so I'll let you know if I get any more helpful information. It would be great if you could continue to share your experience too. There's very little useful information about this on the internet at the moment.

Sarah :)

oh louise what a terrible time you have been having.
There is a Canadian (I think) doctor called Jack Newman. He is most def a bf expert. If you Google him his site will come up. When I was having (minor in comparison) problems I emailed him and received a number of replies. I think he would be worth an email.

Owch sarah...that sounds so sore. The mws probably haven't seen that many abscesses. Refilling isn't unusual and isn't incompatible with healing. Painful though and on both sides...poor you:(

If you are definitely infection free then your wounds should heal, pain from milk accumulating in the cavity can be relieved with a drain or wick or aspiration. There may well be ducts that are now draining milk into the wounds and this milk is not getting further? If you feel feeding makes no difference this could well be the case. Eventually these ducts will cease production as if you have stopped feeding...every section of duct works independently.

Hope you get some useful info on Friday and soon get more comfortable.

Hi 48th, you're right - the doctor confirmed that some ducts have rerouted into the space left from the original infection. He has recommended that I stop bf (said he'd never said that to anyone before, but in my particular case it's the only thing likely to work). I had both sides aspirated again and they have already filled right back up. I'm devastated but know that stopping is the right thing to do, so the plan is to gradually drop feeds and keep going back for aspiration until it heals. I had been expressing a lot, so I have enough frozen milk to at least ensure he's exclusively bf for three months, which I'm proud of in the circumstances!

Sarah that is so tough for you, sorry you have had such a difficult experience but how fabulous that you have your expressed milk too.

It sounds like your doctor is knowledgeable and yes in some cases stopping can speed healing and importantly really reduce the horrible pain. Sometimes reducing is enough but you are right to drop ghe feeds gradually.

Hope you are much more comfortable soon.

Sent you a pm too