Hi Mums,
I've spent the last several weeks dealing with a breast abscess. When I was in the middle of it I honestly felt like it was never going to end.
As I was searching through forums for information I mostly saw posts from others seeking help, but what I really wanted was to hear from someone who successfully made it through to the other side and how they did it. So I thought I would share my story and hope it helps others in the future. I have a detailed timeline below, because when I was in the middle of it I was obsessed with all the details, but here are the highlights:
-I was able to heal and continue breastfeeding with only needle aspirations and antibiotics. My skin never burst and I didn't have to do the Incision and Drainage surgery.
-The local anesthetic used during the needle aspirations is fine for breastfeeding. Many of the technicians who did my aspirations advised me to keep the baby off that breast for a period of time- I was told 2 hours, 6 hours, 12 hours and 24 hours by different people- but when I probed them about it they had no real reason, except "just in case". I think this is deeply irresponsible, as any interruption in feeding for a new mom can be logistically challenging at best and can affect her supply at worst.
-The first breast specialist I spoke to said I had an infected galactocele and told me the only way I'd ever heal is if my milk dried up completely. This obviously broke my heart as my baby was not even 2 months old. I'm extremely thankful that I had private insurance and I could get a second opinion. If you're determined to continue breastfeeding through an abscess it's worth the effort (and/or money) to find a doctor who will support you.
-My infection turned a corner when my new doctor advised me to keep the baby off the infected breast for 48 hours to 'break the cycle of infection'. I pumped and dumped from that side during this period on his advice. His rationale was that the baby and I keep re-infecting each other (I give the baby infected milk and he keeps infecting me through his mouth). On most pro-breastfeeding websites such as La Leche and Kellymom you'll see info that the milk is not infected and you should keep feeding the baby on that side. I can't say for sure what is correct; I can only say that it seemed to work for me. As I said above, it's very difficult for a new mom to have breastfeeding interrupted, but I think it's worth giving this method a try if you're able.
-My absolute lowest point was just before it started to heal. The skin above the abscess was leaking out so much milk I couldn't keep a bandage dry. My doctor had to put a colostomy bag on top of it to collect the fluid. I leaked around 30 ml every 24 hours for 2 days. Obviously this was an unsustainable situation and in my despair I started planning to reduce or stop supply in that breast. But on the third day the flow suddenly stopped. I was able to remove the bag and go back to bandages, and in a few days those bandages were also dry.
Below is the timeline of how the abscess progressed to the best of my recollection. Photos available on request.
Background:
My baby and I started having feeding difficulties at around 2 weeks. My right nipple was deeply cracked and I was having a lot of pain while breastfeeding, including super painful vasospasm. He transfers milk well and is a big 'ol chonk so I basically just gritted my teeth and persevered. I was also taking paracetamol and ibuprofen as I recovered from a tough labor, which both dulled the pain and suppressed my fever, keeping me from noticing my infection. I had 2 lactation consultants, a GP and a health visitor all look at it and they told me I seemed fine and I didn't even have mastitis. So my infection, I assume, kept getting silently worse with no symptoms until I was suddenly in real trouble.
Dec 20- Got the chills, started taking oral Fluxocacilin
Dec 21- My temperature got to 38.5 C/ 101.3 F and I went to the A&E. I was admitted to the hospital as I was septic and tachycardic. Since it was a weekend there was no tech who could perform the ultrasound and needle aspiration so they just put me on IV antibiotics, Co-Amoxiclav, and fluids until Monday morning.
Dec 23- First aspiration, about 60ml of fluid
Dec 24- Discharged from hospital, started oral Co-amoxiclav
Dec 30- Second aspiration, 45ml of fluid. My breast is still very red and the abscess bulges out, forming a swollen lump.
Dec 31- Third aspiration, around 45 ml of fluid, was advised to continue on oral antibiotics
Jan 1- The skin above my abscess began leaking pus through a small hole, the size of a pimple.
Jan 2- Skin over abscess starting to peel, fourth aspiration, around 40ml fluid
Jan 3- Fifth Aspiration, around 30ml
Jan 6- Sixth aspiration, around 25 ml fluid. At this point the skin above the abscess looks red/ purple with veins and more small holes leaking.
Jan 7- Appointment with NHS breast specialist, was told that I'd have to dry my milk in order to heal. Advised to discontinue antibiotics after the 7 day course was finished.
Jan 9- Met with private doctor for second opinion, was advised to keep the baby off the infected breast for 48 hours and to pump and dump. Seventh aspiration, 12 ml of fluid
Jan 10- Dr says the area looks "less angry", Eighth aspiration, 7ml of fluid
Jan 11- Resumed breastfeeding on infected side. The skin around the abscess looked very healthy and normal (instead of red) and abscess seemed smaller/ flatter
Jan 13- Had an ultrasound but the tech said the remaining fluid was too thick to aspirate and would dissipate on its own. I thought I was out of the woods at this point.
Jan 15- Backslide- the skin on my breast was starting to look red again and the abscess area looked puffy. I went to see the doctor and he put me back on a 5 day course of antibiotics, Co-amoxiclav again.
Jan 16- Ninth aspiration, 4 ml of fluid. After the aspiration the wound was leaking quite a bit. That night I had blood in my milk from the procedure so I pumped and dumped from that side until it subsided.
Jan 17- The skin above the abscess was leaking so much fluid that a bandage couldn't contain it. I rushed to the doctor and he had a nurse put a colostomy bag on it. She trimmed the edges away from the nipple so that the baby could still feed.
Jan 17-19- I'm not going to lie, this was a difficult period. Having to look at the wound on my breast and the bag of leaked milk I was carrying around every time I fed my baby was extremely disturbing. I emptied the bag every 12 hours and measured the fluid. I was leaking around 14ml during the day and 20ml at night, so basically an ounce every 24 hours.
Jan 20- The leak suddenly reduced to 2ml every 12 hours, so I removed the bag.
Jan 25- The skin is no longer leaking at all and seems to be healing. Color is slowly returning to normal.
I'll update again when my skin looks completely normal. I hope this is helpful to others who have a breast abscess to know that it will heal and you can keep feeding if that's what you want to do. If you do try the 48 hour method please reply and let people know if it worked!