It is after a few weeks, when the rate of breastfeeding decreases, that the breast abscess most often occurs. It can start with a crevice, which lets a germ on the surface of the skin enter into one of the ducts where the milk flows. Painful redness, slight fever, fatigue … This is mastitis, which affects about one in ten breastfeeding women. Milk does not flow well and stagnates in the breast, causing inflammation.
We rest and we continue the feedings
“Mastitis is treated with paracetamol and an anti-inflammatory: we don’t give antibiotics straight away. Above all, we teach the mother to place her baby with her chin on the red zone, to make the congested part work. Mastitis can then be resolved in two or three feedings. We see the mother again a day or two later to make sure everything is fine. Rest is very important ”, explains Dr Marie-Pascale De-bord, obstetrician-gynecologist.
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The right steps to breastfeed
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When mastitis develops into a breast abscess …
Less than one in ten, mastitis develops into an abscess. The breast is very painful and the fever can reach 39-40 ° C. The abscess (purulent milk ball) can be palpated if it is superficial. If it is deep, it is the ultrasound that confirms the diagnosis. Treatment is the same as for mastitis, but at this stage antibiotics are essential.
When the abscess is too large, it must be emptied. Classic surgery, still the most widely used in France, consists of incising the breast to empty the infected milk and cleaning the area of the abscess, under general anesthesia. The mother remains hospitalized for a week, without her baby. She is therefore forced to stop breastfeeding and it is rare that she resumes it. The healing is quite long and leaves an unsightly mark of several centimeters. It can even complicate future breastfeeding.
Simple puncture under ultrasound
Ultrasound-guided puncture, already widely used in Anglo-Saxon countries, is developing in France. “We aspirate the infected milk using a fine needle, under ultrasound to guide the procedure, then we wash the area with physiological serum to eliminate bacteria, often staphylococcus aureus. It is performed under local anesthesia, on an outpatient basis, by a specialized radiologist or a gynecologist ”, says Dr Debord. Two to four punctures are often necessary, a few days apart. Nine times out of ten the results are excellent. The mother is encouraged to continue breastfeeding, including on the affected side.
Our expert: Dr Marie-Pascale Debord gynecologist-obstetrician at the CHU Lyon Sud in Pierre-Bénite (69)
Where can I find advice on the net?
The Leche League
For further
These Breast Diseases That Are Not Cancer
How to promote lactation
Grandmother’s remedies to heal cracks
