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During nursing, an area of redness, tenderness, and induration may develop in the breast. The organism most commonly found in these abscesses is Staphylococcus aureus. In the early stages, the infection can often be treated while nursing is continued from that breast by administering an antibiotic such as dicloxacillin or oxacillin, 250 mg four times daily for 7–10 days (see Puerperal Mastitis, Obstetrics). If the lesion progresses to form a localized mass with local and systemic signs of infection, surgical drainage is performed and nursing is discontinued.
Causes
When you are breastfeeding, the skin of the nipples can become grazed or cracked. This is usually a result of the babys gums pinching the nipple. Sometimes it happens because the nipple hasnt been far enough into the babys mouth, and has rubbed against the roof of the babys mouth. Many sore nipples are caused by the baby not being properly positioned or latched on.
Breast infections are caused by a common bacteria found on normal skin called Staphylococcus aureus. The bacteria usually get into the breast through cracks or abrasions in the nipple, and the resulting infection causes inflammation of the breast (mastitis). Although mastitis is most commonly caused by breastfeeding, it is also linked to other factors. These include diabetes, nipple piercings, lumpectomies or breast irradiation, the use of corticosteroids, having silicone breast implants, and being a heavy smoker.
Symptoms
The first stage in the development of an abscess is inflammation of the breast tissue. This is called mastitis, and has the following symptoms:
painful localised swelling of the affected breast,
localised redness,
tenderness, and
the breast feels very hot.
If you can, try to continue breastfeeding. Draining the infected milk can reduce the chance of an abscess forming, and it will not harm your baby. The germs in the milk will be killed off once they reach the baby's stomach. If an abscess has already formed, your GP may recommend that you stop breastfeeding.
If you cannot carry on breastfeeding due to pain or because the infection is very advanced, then you should use a breast pump to express the milk.
Another sign of infection is flu-like symptoms, including aches and pains, headache and a raised temperature.
Treat Breast Abscess
Most abscesses will need to be treated with an antibiotic. In many cases, it may be necessary to stop breastfeeding while you are on an antibiotic. In some cases, it may be necessary to drain the abscess in order to get the infected fluid out of the breast faster and speed up the healing process.
Soaking the breast in warm water can often help with the pain and discomfort. If you are breastfeeding, you should avoid feeding your baby from the infected breast until the infection is cleared, even if you are not using antibiotics.
GENERAL MEASURES
Use warm-water (or cold water if it is more soothing) soaks to relieve pain and hasten healing.
Discontinue nursing the baby from the infected breast until it heals. Use a breast pump to express milk regularly from the infected breast until you can resume nursing on that side.
Surgery to drain the abscess (infrequent).
For women who are dehydrated or vomiting, or who have diabetes or an immunosuppressive disease, intravenous antibiotics are usually prescribed. Intravenous antibiotics are injected directly into the blood, and may also be recommended in rare cases of severe infection. Infection that develops into a breast abscess usually needs to be drained. A small abscess can be drained with a needle, sometimes using ultrasound to guide the needle. A local anaesthetic may be given to numb the skin over the infected breast tissue. This procedure can often be carried out at your GP surgery.
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