Breast Abscess And Breastfeeding – 4 Questions Answered

Breast Abscess And Breastfeeding - 4 Questions Answered

An abscess is a localised collection of pus.

Pus is a white-yellow, yellow, or yellow-brown fluid formed at the site of inflammation typically during a bacterial infection.

Breast abscesses can develop from unresolved mastitis, as a result of abrupt weaning or can ‘just appear’.

Breast Abscess And Breastfeeding – 4 Questions Answered

You may have heard of skin or mouth abscesses but you may not have heard of breast abscesses. It’s estimated that between 3 and 20% of breastfeeding mothers develop mastitis. It’s also been estimated that a breast abscess occurs in approximately 3% of women with mastitis.

The usual cause of breast abscess is Staphlococcus aureus, although methicillin-resistant Staphlococcus aureus cases are increasingly being reported in some communities in the United States and Taiwan.

Here are 4 questions about breast abscess and breastfeeding answered:

#1: What Are The Signs And Symptoms Of A Breast Abscess?

Signs and symptoms of a breast abscess tend to be similar to mastitis and include:

  • Malaise
  • Nausea
  • Extreme fatigue
  • Aching muscles
  • A well-defined tender lump in the breast
  • Pus may be able to be expressed out of the nipple
  • Swelling, pain and redness at the site.

It’s important to note an abscess is the body’s defense mechanism, in that the body tries to ‘wall off’ the infected area, preventing the spread further which results in a collection of pus being encapsulated in a cavity.

If the abscess started out as mastitis and then turned into an abscess, because the infection has become encapsulated, the mother does not feel quite so sick.

It’s also important to note there have been asymptomatic cases of breast abscesses.

#2: How Are Breast Abscesses Diagnosed?

Ultrasound examination can be used to diagnose a breast abscess.

Fine needle aspiration may also be used, to remove some of the fluid in the abscess which can then be sent off to a pathology laboratory for diagnosis. If the abscess can’t be felt from the surface of the skin, ultrasound may be used to guide the needle.

#3: What Is The Treatment For A Breast Abscess?

Treatment of an abscess involves drainage of it as well as antibiotics.

Abscesses are usually successfully drained by ultrasounds guided fine needle aspiration (sometimes repeated ones).

If this is unsuccessful, open surgical drainage is required.

#4: Can Breastfeeding Continue When A Breast Abscess Is Present?

Continuing to breastfeed during and after the treatment of an abscess helps promote drainage, and assists with infection control.

Keeping the affected breast well-drained of milk is an important part of the recovery process and helps avoid complications.

If breastfeeding frequency is reduced, the breast can get full, engorged, possibly get a blocked duct, mastitis etc, which are definitely not wanted when there’s been an abscess!

Breastfeeding can be maintained even if the abscess needed to be surgically drained, as long as the incision and the drainage tube are far enough from the nipple/areola so that they do not hinder a baby from attaching to the breast.

In any event, the breast should be expressed often to maintain the milk supply until breastfeeding can be resumed.

Rarely does an abscess burst through into the ductal system and so milk from the affected breast generally remains uncontaminated (i.e. without pus). Most abscesses are diagnosed and treated before rupture could occur, and depending on the depth of the abscess, it may rupture preferentially onto the skin.

However, if there is pus coming out of the nipple, the mother would express and discard this, even though a baby can ingest pus accidentally without many problems. If it upsets the baby, he’ll just vomit it back up but it’s not a problem infection-wise. One would need to be more cautious if the baby was premature or immunocompromised in some way.

If you’re breastfeeding and concerned you may have an abscess be sure to seek medical advice urgently.

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Renee Kam is a mother of two daughters, an International Board Certified Lactation Consultant (IBCLC), a physiotherapist, author of 'The Newborn Baby Manual' and an Australian Breastfeeding Association Counsellor. In her spare time, Renee enjoys spending time with family and friends, horse riding, running and reading.

One comment

  1. Hi Renee,

    So I had a very terrible breast abscess that drained up to 500ml of pus. Somehow the breast got reinfected and another incision had to be made. Weeks after, I still go for dressing and the surface of the wound won’t heal, so I’ve beeb advised to quit breastfeeding. The matron advised I do it cold turkey and I am afraid as I think it was engorgment that got me here in the first place. What are you thoughts?

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