Breast abscess, treatment and breastfeeding

[Stardust91]

Sorry for the long post.
I am in my home country and had to go to the emergency room of our local hospital (i had a red swollen patch on the top part of my breast). After a look from the duty doctor she said that she needs to make an incision and drain the pus out.
She did it without any type of pain relief or anaesthetic. The pain was horrendous and the whole process felt disorganized. She was a junior doctor and a senior surgeon walked in and asked her why the hell she started the incision without a nurse to help her. (She said she asked but they said they were busy). He went outside and started shouting at a couple of nurses who came in and started helping. The surgeon kept barking orders at the junior doctor. Apparently, she wasn't doing it correctly and wasn't draining the pus out properly. Meanwhile, i was wishing i could pass out.
Eventually, the ordeal was over and i was told that the wound needs to be kept open so it will keep draining (?).
Did anyone else had an incision to treat an abscess? Did they keep it open? For how long? Did they give you any kind of pain relief during the incision?
I am also EBF and it's so hard at the moment. I am feeding DS from my other breast but apparently i need to remove milk from the breast that has the incision but not by feeding baby. Because of the dressings I can't use a pump. I hand expressed a bit but the movement caused the wound to start bleeding and now my dressing is soaked. Does anyone has experience with this? How much milk i need to empty?
I am close to tears because i fear this might be the end of my breastfeeding journey and baby is only 2.5 months. I wanted to at least reach the 6 month milestone.

Sorry I can’t help, but bumping this for you.
If you’re on Facebook there are bf groups where you might get more/quicker answers

That sounds horrendous - I'm so sorry :(

I can't relate to your experience but I am EBF my little one. Long story but I pretty much stopped feeding on my left side for a couple of weeks and my milk supply dropped massively. If you can just hand express a little to stimulate your nipple (trick that side to thinking your still feeding) and feed on the other side when your better you can build your milk supply back up thanks to supply and demand :)

Mines still not great I can express 5 ounces on the left and 8 ounces on the right but it's a massive improvement. Hope this helps a little :( sorry again.

@NeptuneNellie thank you for your reply, i hadn't thought about bf groups on Facebook i will have a look, thank you!

@Justanothermum95 thank you for replying! I started pumping my 'good' breast in hopes of increasing the supply. Trying to trick my body into thinking that lots of babies are feeding from that one. Ironically, my abscess breast has lots of milk but doctor said not to feed baby from there. So now i have to keep pumping to empty it.

Hi @Stardust91.
I am so sorry you are going through this. I understand your pain. I can tell you that it does get better. I had a breast abcess which turned into a galactocele once the infection was gone. It has gone from 100ml big to 10ml...... So I am nearly done! I had my abcess aspirated (drained) twice a week for 6 weeks, then down to weekly and now bi-weekly. They talked about leaving it open but I asked for it not to be. It was very painful the first 4 times I had it aspirated & I could barely lift my newborn for a day afterwards until I found an ex surgeon turned sonographer at my local NHS hospital who is magic. I had mastitis as well (same breast) so I have basically shut down the poorly breast (now can only pump 5-10ml) my "good" boob has boosted supply and lo is as chubby as can be from one side. Sending you a hand hold.

Also I was given a sort of bag you stick over the wound as I developed fistulas. Could you get hold of one of these? It would catch any puss & milk making you feel more comfortable.

Can you get on the 'la leche league international' fb group?
That's sounds horrid

@LayTheTableMabel thank you for posting your experience. No chance of getting a bag to put over the open wound. They didn't even have sterile gauzes to cover it and had to look around to find any. (The hospital in my home town is that bad, no funding or capable staff). Hopefully, when i get back in the UK things might improve and i can get better treatment

When you had it aspired each time how did they do it? Did they had to open the wound every time? (You mentioned you didn't want it left opened) Or did they use the syringe method of emptying the fluids? Did they give you any pain relief/local anaesthetic when they were doing the procedure every time? Sorry for so many questions i just feel so lost.

@Foodylicious thank you for the suggestion. I found their page and i am having a look at it.

Hi Stardust, where the doc aspirated first he went directly down into the abcess with the biggest needle I have ever seen. This caused channels which couldn't close up. So milk streamed out of them. The surgical consultant said they were rare and wouldn't close unless I quit bf.... They did & I didn't. I then got a different doctor who accessed the abcess from the other side of my breast iyswim. This hAs been far better. I have insisted on anaesthetic every time, the best way is if they load the needle & insert small amounts every little bit they go in. If the anaesthetic is inserted into the milk/pus it doesn't work (so doc told me). Once when the skin itself was agony they gave me skin numbing cream, then injected anaesthetic. Sorry my answers are so long winded, I'm happy to answer anything if you can keep up with my sleep deprived rambles. 😁

With regards to an open wound they pricked the skin with a knife tip as the needle used was too large to comfortably break the skin. Until the fistulas developed I didn't have an open wound as such.

@LayTheTableMabel thank you for your replies, you can't see it but i am mentally holding on to you with both hands.
did the doctor say anything about feeding from that breast? Ie. Dangerous for the baby because pus is mixed with the milk.
I have lots of milk coming out of that breast and it's going to waste. I have been told i need to pump it constantly so it's empty, but the more i pump the more milk i seem to be getting. Meanwhile, I think my other breast is not producing enough milk because baby keeps crying after each feed for the last couple of days and shows signs of wanting more but gets frustrated after a few sucks on the 'good' breast.

Hi @Stardust91. I am so happy to turn what has been a very difficult experience into something positive by sharing with you. I was told to feed as much as possible from that breast. This is backed up by kellymom
kellymom.com/bf/concerns/mother/breast-abscess/
Your baby won't get any infection but will help you to heal quicker by emptying your breast. Your baby will drain the milk far better than a machine. The more often that you pump or feed the more milk you will produce- supply and demand... So if baby has a growth spurt they can increase how much milk you produce by feeding more. So the more you pump the more that breast will produce. This also means that within a couple of days one breast can boost its supply to support your baby- I now feed solely from one breast as my poorly breast was so damaged.
On a positive note 3 months after all this started an I have been discharged from hospital care this morning! 😁

@LayTheTableMabel That's brilliant news! That was a long journey the 3 months!

Thank you for the link! The doctors and nurses here are a bit clueless and they won't give me a straight answer about anything in regards to BF. I was even told not to take ibuprofen for my discomfort because it will pass on the baby, but i could have sworn my midwife said it's fine when breastfeeding and all over the internet it says low risks.
Did they give you any antibiotics to take when you started your treatment?

Hi Stardust. Yes you are right you can take ibuprofen at normal levels. It sounds very challenging with the conflicting advice you are getting! I had antibiotics & they tried 4 different ones until they found the right one, they did this by sending a sample of the milk off to a lab and working out which antibiotic worked- I don't know if that is an option where you are?

Sorry to hear your story Stardust. I've also had a breast abscess which is now almost completely gone, so I know how agonisingly painful they are. My baby could never latch, so I was expressing for her when I developed the abscess. I had it aspirated by needle about 6 times over the course of a few weeks, and thankfully they didn't need to open it up. I had intravenous antibiotics for 2 days, then oral antibiotics for a week after that. They took a sample of the pus to check what antibiotic would work best. Our breastfeeding journey felt like it was plagued with problems from the start, and by the time the abscess developed my LO was 2 months and a lot more awake and alert so I opted to stop expressing and focus on her rather than the pump! My bad breast had pretty much stopped giving me any milk via the pump anyway. As a PP said, the Facebook groups are helpful to get advice from others who have been in the same position.

They took a sample but they just looked at the results and went ' oh good results, great, no bacteria growth (?)'. They had already given me co-amoxiclav to take.
I am back at the uk now and waiting for the breast clinic referral.
The wound is still open and i swear it doesn't look like it's getting smaller. I am changing the dressings on my own now.

Hi OP this sounds so hard, poor you, you sound like you’re doing great in such a difficult situation. I don’t have experience but having had mastitis a few times I’ve read a bit about abscesses and I’m sure I read someone talking about getting a flange cut for your pump so that it avoids your wound. Not sure where you’d get this but maybe contact the pump company for advice? I agree kellymom is great and her advice is certainly to be trusted. If you are pumping very frequently you are likely to end up with an oversupply problem that you don’t want.

Thank you for your reply, merename.
The wound is high enough for the pump to attach fine. And i did end up with more supply in that breast! The irony is the surgeon kept saying on the appointments to change my dressing that i am not emptying my breast enough and i should keep up with it because breast is too full. I wanted to shout at him that pumping was causing this problem in the first place! I have now though let the baby take control of that breast again so thankfully the milk supply has reduced.

Pumping pals flanges are shaped differently which makes it easier to avoid an abscess. They are made in the US though and I couldn't find a supplier in the UK. You can have them shipped over but would cost about £50.

Thank you for looking, imicola. I will have a look, but currently not pumping that breast anymore. I have let baby feed from it again.

Sounds like a good move stardust! I hope you start to heal, but I think the wound heals from inside out so it may take a while to look better. And hoping the breast clinic are helpful. Getting a good breast surgeon made all the difference to me!

Hi Stardust, pleased to hear you are back in the UK. I hope you get a great NHS team to help you. Sounds like you have done all the right things so far. Thinking of you.

Good that you are out of that awful hospital and in the UK
Ask to see the breastfeeding expert in the hospital.
If there isn't one/ they've not come across your situation before then you need a lactation consultant. They are like the doctors of the bf world. Have seen everything. Costs money but cheaper than formula in the long run.

Yes bf from the affected breast!

Glad you got some good advice on here. I ended up with a breast abscess after mastitis. It was aspirated once under local anaesthetic. It was very big. I have a permanent dent in my boob which I hate. I was lucky as I was treated at a specialist breast unit in the big city in which I live. They then packed the wound and it took about 6 weeks at least of it being dressed before I could stop going to nurses appointments twice a week. It was truly hideous.

The worst bit was when I was first breastfeeding again, and you know how the milk gets let down, and a whole load of milk spilt out of the abscess hole and all over my poor little boy. It was grim. I got really freaked out and sent DH to give DS a bottle. It was really upsetting.

I didn't have anything against formula feeding, it was just that I breastfed ds1 and I knew how easy and convenient it was compared to having to worry about bottle feeding. So I really persisted in keeping up breastfeeding DS2.

I was actually told not to breastfeed from my affected breastby the breast surgeon who aspirated the abscess. However I was dealing with doctors who knew more about breast cancer than breastfeeding. I found Kellymom very useful. When I went back I spoke to the doctor about what had found out and he agreed that actually I was right to have continued breastfeeding feeding from the affected breast.

For me continuing to feed on the affected side help me get rid of the mastitis. It was painful but better than pumping.

I end up feeding my son till he was 2. So it had a happy ending. Just a shame my poor boob is not the same anymore.

So I wanted to offer my sympathies and share my experience. I think the worst of it is over for you now. It seems you are getting the good medical attention that you need. Wishing you all the best for a speedy recovery and to continue with your breastfeeding, you have done so well.

@ZenNudist Thank you so much for sharing your experience with me. I was told the same from the surgeon about bf from that breast but as you said i don't think he knew either much about bf. It's quite frustrating really. I also had lots of milk coming out of the incision, it was horrible, especially at night.
@holidaylady thank you for the advice
Thank you @imicola, @laythetablemabel for your ongoing support in this thread.

Mini update.
The wound is still open but has finally gotten smaller. No more milk is coming out of it. I am still changing dressings and hope it will soon completely close. The sticky part of the dressing has started making my skin very itchy. It looks like a minor allergic reaction. Least of the problems on that breast really!

Baby is feeding normally from that breast. A part of me is terrified of the same thing happening again.