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While breastfeeding can be wonderful, sometimes it can get complicated. For a nursing mom, a breast abscess can be a difficult complication to manage and overcome. The good news? It can be treated, and it doesn’t mean your breastfeeding journey has to end.

An abscess is a collection of pus that has formed in an enclosed space. This pus is produced by bacteria, which expands and causes the surrounding tissues to stretch, leading to pain and swelling. Also known as boils, they are often found in the armpit, groin, or around a tooth or hair follicle.

In a breastfeeding mom, abscesses can form in the breast. This can develop when an area of milk is not draining well, such as with a plugged duct or as the result of untreated or incompletely treated mastitis. In fact, about 3 percent of women who are diagnosed with mastitis will go on to develop a breast abscess.

Symptoms include a hard, painful lump or swelling. The skin around the swollen area may be hard, red, and hot to the touch. When pressed on, they can cause exquisite pain.

A breast ultrasound can help to diagnose a breast abscess. A collection of fluid enclosed in a capsule-like space can be seen on imaging.

Antibiotics alone are not helpful in treating a breast abscess as they are not able to penetrate the wall of the abscess and get to the bacteria inside. Instead, draining the abscess is the main way of treating this complication. Often a needle will be used to aspirate, or empty, the abscess. Sometimes more than one aspiration is needed. If this doesn’t work or the abscess is very large, then opening the abscess with a small incision and draining the fluid may be necessary. This is often done in the operating room for good pain control for the mother.

Occasionally a tube-like drain will be left in place to make sure the abscess will keep draining the pus and prevent it from building up and forming again. Antibiotics may also be given to help with treatment, but keep in mind that they will only work if the abscess is also drained.

Some women are told they need to stop breastfeeding if they develop an abscess, but this is not true. In fact, continued nursing is encouraged as it is important to make sure the breast keeps draining so there isn’t stagnant milk for bacteria to grow again.

When it comes to the diagnosis and treatment of a breast abscess, often multiple people are involved: lactation consultants, OB/GYNs, and sometimes breast surgeons. It can be a stressful time for a new mom, but with the right support and therapy it is often a complication that can be overcome.

Takeaways

  • An abscess is a collection of pus that has formed in an enclosed space. 
  • In breastfeeding women, abscesses can form in the breast. 
  • About 3 percent of women who are diagnosed with mastitis will go on to develop a breast abscess. 
  • Treatment is usually a combination of draining the abscess and antibiotics. 

References

  1. The Academy of Breastfeeding Medicine. Clinical protocol #4: Mastitis, revised March 2014.  

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