July 28, 2019

Breastfeeding? That Hot, Hard, Painful Lump in Your Breast Might Be an Abscess

A breast abscess can develop with or from mastitis

Mom has breast pain after breastfeeding

Mastitis is every breastfeeding mom’s nightmare. (That, and teething babies.) An infection that causes breast inflammation and makes you feel flu-ish all over, mastitis is a pain in the … well, you get it.

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And while mastitis is treatable with antibiotics, some women will develop a full-blown infection known as an abscess.

“A breast abscess is a walled-off collection of pus that is extremely painful,” says Ob/Gyn Ashley Brant, DO. “Fortunately, it’s treatable, and it doesn’t mean the end of breastfeeding.”

Here’s why you might develop an abscess while nursing and when you should see your doctor for treatment.

Why does a breast abscess form?

A breast abscess usually starts as mastitis because a lactation duct doesn’t empty and becomes plugged. Any nursing mom can get mastitis. It often develops when moms wean their babies too quickly. Other risk factors include being overweight and smoking (in case you needed another reason to avoid smoking).

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In some cases, a break in the skin (watch out for baby’s dagger-like nails) can become infected and worsen with time.

Mastitis symptoms include:

You know mastitis has developed into an abscess when you feel a hard, red, fluid-filled mass on your breast that is very painful.

Mastitis symptoms? See your doctor

“At the first sign of mastitis, contact your doctor to let them know what’s going on,” says Dr. Brant. “Depending on how severe your symptoms are, your doctor may want you to start on nursing-safe antibiotics immediately.”

Dr. Brant says that you can and should continue nursing, even if you begin a course of antibiotics. She offers these additional tips:

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  • Use a hot pack to relieve the pain and reduce swelling.
  • Empty the clogged duct by gently massaging the area.
  • Position your baby so their chin is pointing toward the blocked area (babies most effectively empty the area where their bottom jaw is).

“Your Ob/Gyn may refer you to a breast surgeon or general surgeon,” says Dr. Brant. “Treatment for a breast abscess is usually done as an outpatient procedure.”

To drain the abscess, your doctor may use:

  • Needle aspiration, inserting a needle into the pocket of infected fluid to suck out the liquid.
  • Incision and drainage, making a tiny incision over the fluid-filled mass to drain it completely.

After your provider drains the abscess, you can continue to breastfeed (though you may experience some discomfort as you heal). Continue to use moist hot packs and keep the area clean to speed your recovery. Soon, you’ll be back to pain-free nursing sessions in your favorite chair (feet up and a tall glass of ice water by your side, natch).

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