Do I have a breast abscess?
You may be in a situation at the moment where you think you have a blocked duct, but even after all the usual measures to get rid of it, you can STILL feel a lump in your breast, which doesn’t appear to be going away at all.
In this case, you may have an abscess. However, it’s possible that it could be something else entirely, e.g., a benign cyst, so ask your doctor for a referral for an ultrasound scan of the breast.
This is a painless scan which will help to identify what the lump is.
This form of scan uses high-frequency sound waves to create an image inside the breast. It’s important to empty your breasts as much as possible beforehand, enabling the technicians to have a better chance of reading the results more accurately.
So what is an abscess? It’s a painless or painful swollen lump that you can feel under the surface of the skin, on the breast, although it can be in other places as well. It is an enclosed area of pus, although you are unable to treat it with regular antibiotics.
Some women with breast abscesses feel no pain at all and only have a red patch on the breast as well as a lump.
Others have had a fever and felt some pain as well as identifying a lump – so it can be quite variable.
An abscess usually starts with an episode of breast engorgement. It may be that your baby hasn’t been feeding well at the breast, or has missed a feeding, which has led to engorgement.
The engorgement is congestion of milk (milk is hanging around going nowhere, and suddenly a duct becomes blocked), blood and lymph.
If the blockage is not relieved, the milk inside that blockage leaks out into the surrounding tissue and can cause a general inflammation of the breast, which is called mastitis.
Unrelieved mastitis can lead to a bacterial infection and a breast abscess.
It’s also important to mention that an infection of the breast can occur through sore, cracked nipples, so it’s essential to pay attention to your baby’s latch and ensure that you are comfortable when you are feeding.
If you have an abscess diagnosis, it can seem like a terrible turn of events. Many women think that breastfeeding has to stop at this point.
The great news is, however, that it is treatable, and there are ways to move forward, starting with abscess draining.
Drainage of the abscess is carried out with a needle and syringe. Often this is all that is needed.
Some women have to go back a few times to have it re-drained, but if it is a larger abscess, you may need to have a small incision made to allow the pus to come out.
If these measures have not resolved the situation, you may need to have it surgically drained, and often done under a local or a general anesthetic.
If you do have to have an incision made in your breast, talk with your doctor. You need to be aware of your options regarding the type of cut made.
Cutting around the areola area can cause damage to the ducts inside the breast, potentially reducing your milk supply.
The way the cut is made will give you options for now and for any future lactation as well.
Once the procedure is over, your doctor will send off the pus to have it cultured, allowing for the prescription of a specific antibiotic, which will directly target the identified bacteria.
You may be wondering whether it’s possible to carry on breastfeeding or whether you will need to stop breastfeeding in this situation.
The great news is that it is still possible to continue feeding.
You may even continue to feed on the side where you’ve had this procedure, as long as the incision and the drainage tube is far enough away from the areola area and the nipple, so that your baby can still latch and feed.
Whether your baby is feeding on that particular breast or not, it’s still imperative to keep your breast drained as well as possible, either pumping or feeding.
The most important thing is to prevent blocked milk ducts, engorgement, and mastitis.
Sometimes there are situations where women diagnosed with a breast abscess and have been told by a member of staff at the breast clinic, that it isn’t possible for breastfeeding to continue while the drain was in-situ. Some have said that the wound would never heal, which isn’t true.
Breast milk has lots of antibodies in it, which help to prevent infection, and although it may take a little bit longer for the wound to heal, it will heal up.
Be encouraged that with the right antibiotics and with continued emptying of the breast and prevention of blocked ducts, even as you continue to breastfeed, the healing process should only take three to four weeks.
Also be reassured that if you are not able to feed on the side that has been affected, you can continue to breastfeed on the other breast, because breasts work independently.
Your body will make all the milk that your baby needs from the unaffected side, and although the supply will drop on the affected side, it is possible to reverse this at a later date, so breastfeeding can certainly carry on.
To help you to get past the next three to four weeks of healing, it’s really important that you spend lots of time with your baby, getting lots of rest and eating well in order to keep your energy levels up.
Accept all the help available from your family or friends if you are in this situation. Help with household tasks can release your time so you can concentrate on feeding and healing.
So to reiterate, if you think that you are developing an abscess, please seek out skilled lactation support as soon as possible and get prompt treatment.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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