Breast abscess

When mastitis is not treated promptly, a breast abscess can form. This may require the mother to go to hospital and have the abscess surgically drained. In some cases, the mother can avoid hospital but, over several days, her medical adviser will drain the abscess using a syringe. This does not mean the end of breastfeeding. However, if the drain in the wound is close to the nipple, the baby may not be able to attach to that side for a while. It is still important to keep the breast well drained by feeding the baby or by expressing.

Some people believe that while milk is leaking from the drain, the wound will not heal. This is not true and, in fact, immune factors in the breastmilk help to prevent further infection. It can be very messy though, as the milk will tend to leak out each time the let-down reflex occurs.

Here is a quote from a textbook for doctors about breastfeeding:

"Breastfeeding can be maintained when the breast is surgically drained as long as the incision and the drainage tube are far enough from the areola so that they are not involved in feeding. In any event, the breast should be manually drained of milk frequently to maintain the milk supply until breastfeeding can be resumed (sufficient healing usually occurs in four days). With adequate antibiotics and careful but thorough draining of the breast by suckling or pumping, healing gradually takes place even while the mother continues to lactate. The mother should be instructed to press firmly over the incision with sterile gauze to keep milk from flowing from the wound during feedings. It will heal completely within 3–4 weeks." (1)

Here is another quote from a textbook for Australian health professionals:

"Breastmilk leaking out though the incision may be an inconvenience, but it will not prevent healing." (2)

A mother’s story:

"When I had my abscesses, I ended up removing the sterile gauze and tape and feeding with a cloth nappy nearby to keep us both from getting completely drenched. I would then put fresh dressings on after each feed, as milk, blood and pus pours out of the drainage holes initially when you do feed. I was told that my wound wouldn’t heal until I weaned but this is a common misconception. If you don’t drain the breast regularly, you get full and engorged and are likely to end up with blocked ducts or mastitis again. My surgeon told me the best thing I could do was to feed as regularly as possible and that would speed recovery."

References:

1. Lawrence R, Lawrence R 2011, Breastfeeding: A Guide for the Medical Profession. 7th edn. CV Mosby, St Louis. p559.

2. Brodribb W (ed) 2012 Breastfeeding Management 4th edn. Australian Breastfeeding Association, East Malvern, VIC.

Also see:

The Academy of Breastfeeding protocol on mastitis/abscess.

The information on this website does not replace the advice of your health care provider.

© Australian Breastfeeding Association, January 2016

Last reviewed: 
Jan 2016