Breast abscess - told to only feed from one side

[MsTada]

I'm currently being treated by the breast clinic for a breast abscess. This has been getting steadily worse over the past couple of weeks after I was repeatedly assured that I had a blocked milk duct rather than an abscess. I was also initially on the wrong antibiotics for 9 days, before a sample/culture showed that my infection was resistant to the antibiotics I'd been given. My antibiotic was changed yesterday afternoon. I had a needle aspiration on Monday, and the plan was for a repeat aspiration today; however, over the past couple of days the skin on my boob has broken down further, and I effectively now just have an open wound/wounds which have been oozing and leaking pus.

The consultant who saw me today therefore advised against a further aspiration today, and instead they've applied a proper dressing and are going to review me again on Friday.

She's also advised me to stop feeding from the affected breast in the meantime, to try and give it chance to heal. She's told me not to pump either, but just to hand express/massage minimal milk out if I feel like I absolutely have to ("if I feel like I'm going to explode").

It's now been about 11 hours since I last fed from the affected boob and I'm really struggling. It feels very hard and uncomfortable. I've tried hand expressing, but very little comes out (I've never been any good at hand expressing and don't tend to get on with breast pumps either).

Has anyone been through similar and can offer any advice?

Also, has anyone had to stop feeding from one side for a time and then managed to successfully resume feeding from both sides again afterwards? I'm keen to carry on breastfeeding if at all possible as I've struggled with OCD in the past and the idea of ensuring bottles are sterile and that formula is made and stored properly fills me with dread.

I had the same but it was 18 years ago. They told me to keep feeding, it was agony, I was shaking with the pain. Maybe try to express in a hot bath? This isn’t much help to you but sending supporting thoughts and hope you recover soon whatever happens. I did heal and carry on feeding.

Thank you! A warm bath/shower is a good idea. I'll try that.

I don’t have great advice but wanted to bump for you.

I really feel for you OP, I hope it gets better soon.

I feel a bit out pf my depth advising you myself and do really feel for you.

Have you spoken to a BFC on one of the BFing Helplines?

Oh and I’ve found this article on Kellymom. I don’t know if that will be of any use?

Thank you for the links! I haven't called the breastfeeding helpline, but I've spoken to the local infant feeding team and they're going to call me back this morning to try and arrange an appointment, so that's something positive!

The Kelly mom website advises continuing to feed, as does pretty much everything I can find online!

Haven't tried the warm bath idea as I've been told to keep the dressing dry (didn't think of this earlier after a night of no sleep!)

It's so frustrating having a hungry baby whose constantly sucking on a boob that feels empty, while I have a boob that's so full it's painful that I'm not allowed to give him! He's so far refused a top up bottle but I'll have another go with that this morning, as I don't want to leave him hungry!

Edited to apologise for the overuse of exclamation marks.

Don’t worry about the exclamation marks, you have plenty of other things to be talking up your time

How did the call go this morning?

The call from the feeding team was okay, but she was very surprised that I'd been told to stop feeding. She actually called the breastfeeding clinic and spoke to one of the doctors there to challenge it, but they advised her that two separate consultants had discussed and agreed this plan.

I went back to the breast clinic for a review yesterday, and the wound looked better then it did on Wednesday. The different openings in the skin had all joined together so it's now just one larger hole/wound. They've scanned it, put a new dressing on and I'm to go back on Tuesday for another review.

Yesterday they told me that it was up to me to decide whether to resume breastfeeding from that side again. They said it would take longer to heal if I breastfed as the breast would be more "active", but it would still heal. They felt it would heal quicker if not breastfeeding as the rest/lack of activity would help with healing.

I've chosen to breastfeed from both sides again for the time being, and see how things go over the next few days/weeks. I found the discomfort from not feeding added to the crappiness of the situation, and feeding itself doesn't seem to increase the pain on the bad side now that the abscess has been draining and the wound is dressed. If it starts getting worse or isn't healing well then I'll have to rethink, but that's the current plan!

Hi @MsTada I'm in the same position. I currently have an abscess, which I've had for 4 weeks. It was drained last week, but it is still infected and oozing. The doctor reviewed it today and suggested I should stop breastfeeding on the affected breast, which was a surprise to me and felt quite a drastic measure to aid healing. I have a follow-up ultrasound in the next few days to see if the abscess has refilled. I will use that to assess what I want to do. But like you I want to breastfeed. It would not be an easy decision to wean a breast, and if I must I would consider reducing the supply in that breast, with the hopes to increase it again in the future. But I'd need some guidance on how to do this.
I hope you heal well

Sorry to hear you're in the same position. It really is rubbish!

I did stop feeding from the affected breast for a few days on their advice, but in hindsight I wish I'd challenged this more and looked to reduce feeding more gradually if absolutely necessary, rather than just stopping cold turkey as advised (they told me not to pump or feed at all, and only to have excited a minimal amount if I 'felt like I was going to explode').

Stopping cold turkey made for a really uncomfortable few days, and things have felt much better since I've started feeding from both sides again.

It also definitely impacted my supply significantly, and I'm now trying to feed as much as possible to get things back on track. The health visitor is coming to weigh my little boy tomorrow, so that will give me a clue as to whether continuing to breastfeed is viable or whether I need to switch to mixed/formula feeding.

If I was in your position again then I'd definitely try and discuss more of a plan to stop gradually. I really hope things improve for you soon! x

@Waitingformystork@MsTadahi both, I’m also worried I have the same thing. I’ve had a sore/tender section of my boob for 2 weeks now. I went to the GP last week as I was worried I’d had it for a week and it wasn’t getting better with ice/ibuprofen etc. She assured me it was just a clogged duct. But now it’s been TWO weeks?! It’s really getting me down. How did you know yours was an abscess? Really sorry you’ve been going through it too, breastfeeding is not for the faint hearted! X

I wasn't diagnosed with an abscess until it started leaking pus.

I started with a red, hot, sore patch on my boob. I went to an out of hours GP who diagnosed mastitis and prescribed antibiotics. He told me to go to hospital (maternity triage as less than 6 weeks post birth) if no improvement after 48 hours of antibiotics.

2 days later I went to maternity triage as there had been no improvement and I now had a hard lump/wedge under the red patch and my boob was misshapen. I was told it was a milk duct and to continue with the antibiotics.

3 days after that I had an appointment with my community midwife, who told me it was a clogged duct and I needed to massage it out in the shower.

The next day i massaged in the shower as instructed to try and unclog the duct, but pus started coming out of the little glands around my areola (not the nipple). I went back to maternity triage and they said I had a breast abscess. At that point, they took a sample of the pus to send for testing and referred me to the breast clinic. I was seen in the breast clinic 2 days later - they said they would have got me seen same day if it wasn't a Saturday, but the breast clinic only runs Monday to Friday. The breast abscess was diagnosed with an ultrasound scan, and they did a needle aspiration at the same time.

A few days later the swab showed that I had an MRSA infection that was resistant to the antibiotics I'd been given, so they changed the antibiotics.

The diagnosis of a breast abscess was confirmed with an ultrasound scan when I was seen in the breast clinic after the pus appeared, but I think i should have been scanned for an abscess when there was no improvement on the antibiotics if NICE guidelines were followed.

The NICE guidelines are here: https://cks.nice.org.uk/topics/mastitis-breast-abscess/management/

The guidelines seem to suggest that you should have been prescribed antibiotics if no improvement in your symptoms after 24 hours, so it might be worth another visit to your GP, or even your local maternity triage if you've only recently had a baby. If you think it might be an abscess then I'd push for either a referral to the breast clinic or an ultrasound scan to check.

I wish I'd pushed for this sooner as things were quite bad by the time I was seen in the breast clinic, the skin had broken down and pus was oozing through the skin, and I've ended up with quite a large wound. I would definitely go back if you're still having issues after 2 weeks.

Sorry for the late response, and I hope everything was sorted for you!

My gp suspected I had an abscess after he had prescribed me antibiotics and the lump had grown in a week, rather than reduced. I was recommended to go to the surgical assessment unit in the hospital to have it drained. They wanted to refer me to the breast clinic, so it could be confirmed with an ultrasound and aspirated with a needle, guided by the ultrasound. Otherwise, the SAU would have done an incision, which would have been more invasive and taken longer to heal. My referral to the breast clinic meant I didn't have an appointment for 2 weeks.

I went back to the SAU after a week when the lump was more red and had increased in size. They tried to aspirate it with a needle, but didn't get anything. The next few days I had a lot of bruising and the abscess developed a head, which burst, oozing pus (lovely) on the day I was seen by the breast clinic.

If it's an abscess the pus will eventually work its way to the surface, as your body wants to drain it. Having it drained by the breast clinic is more effective though to help with recovery.

I hope you and @MsTada are now both well. I didn't have the abscess but the infection was radiating red lines and I was running a temperature by the time I saw a GP. He was concerned about sepsis. So horrible antibiotics which thankfully worked.

I'm glad the antibiotics worked for you!

They eventually worked for me after I had the abscess drained, but I'm still healing from where the abscess was.

@Waitingformystorkhow are you doing now? I am still living in abscess hell, 8 weeks of it now!!!! I got sent to the surgical emergency unit and they didn’t know what it was?!?! Got referred to breast clinic for an ultrasound and they also didn’t know what it was. I then had to have a biopsy which was soooo painful and it still sore 2.5 weeks on! The lump is barely responding to antibiotics and apparently there’s nothing to aspirate, the lump is inflammation. But the biopsy came back as an abscess? Sorry, I feel like I’ve written that in terrible English but I’m just sooo mad and pissed off that this has happened to me and I can’t see a light at the end of the tunnel yet 😩😩😩

@MilsCookie I'm still healing. My wound over granulated, so breast tissue was protruding from it which prevented the skin from healing over. That was dealt with dressings, and it had almost completely healed, and now it's over granulated again, so the wound has reopened. It's not reinfected though, so that's a positive.
I'm sorry you are going through this. It sounds similar to my initial experience with the SAU. I hope they can at least give you a treatment plan if it is inflammation, or that the antibiotics start doing something. If the biopsy says it is an abscess I would maybe ask for another ultrasound at the breast clinic. Abscesses can grow quickly, so it might be more obvious now

@Waitingformystorkmy god that sounds awful! Are you…okay? How bloody shit is this for us? I know different situations but ffs why has this happened? 😩 I didn’t even know over granulation was a thing?! Glad yours hasn’t got reinfected and really hope it heals properly soon and this is all a thing of the past.

Thank you. I have another appointment on 10th March and they’ve requested another ultrasound. I’m really hoping they see something they can drain, or that at least by then the lump/inflammation around the abscess has gone down because it really is quite painful. And I don’t want to just be living on antibiotics and ibuprofen! I’m just frustrated that when I was initially seen by my GP one week after it being there, I was just told it was a blocked duct, when in my gut I knew it was something more than that. But because I felt well in myself, no fever etc, then it ‘couldn’t be’ an abscess. I’ve not had a fever or any other symptoms, other than tenderness!

@MilsCookie thank you, I feel OK :) As it's under a dressing I don't think about it much. Although it's sore, and it's been a long time now - most of my baby's life. When it was an abscess I would see it every time I would feed my baby, and I felt a awful about it.

I hope your appointment on the 10th March goes well! That feels so far away doesn't it? I would get frustrated by how far apart my appointments were with a condition that could lead to sepsis at any point and get worse really quickly.

That is frustrating about the GP. I also had no other symptoms other than a red lump at first. I guess they don't always make the right diagnosis, and why you hear so much about having to advocate for yourself. Which is easier said than done!

I had a breast abcess, about 30 years ago with DD1.
ABs didn’t help and I eventually had to have it excised under GA in hospital as an emergency while we were away at my parents for the weekend. DF was about 3 months. I’d already stopped breastfeeding because of the pain.