A breast abscess, the worst case scenario, is a very rare occurrence, but can result as the sequela of mastitis. It usually does not happen unless a mother completely ignores her plugged ducts and mastitis, and it occurred more commonly a generation ago, when women were told that having mastitis meant they had to wean their babies completely. In an abscess, the hardened knot in your breast fills with fluid or pus, like a boil, and must be opened and drained by a doctor.
Even a breast abscess does not mean you have to give up breastfeeding. When the doctor drains the abscess, make certain that he does not make his incision in the areola, which might make nursing difficult afterward. You should be able to nurse again 12-24 hours after the surgery, if you choose to.
How can plugged ducts and mastitis be prevented?
Knowing the causes of plugged ducts and mastitis, mentioned above, will help you prevent them. Avoid abrupt changes in your nursing schedule. If you are trying to eliminate feedings or pumping sessions, try not to drop them more quickly than one about every three to four days. This might require a little bit of advanced planning, especially if you are making a major change such as a transition back to work. Understand that since a pump cannot empty a breast as effectively as a baby can, abruptly substituting several feedings with pumping sessions can lead to a buildup of milk that may cause a clog.
Anything that compresses your breast tissue can predispose you to a plugged duct, so you should avoid wearing overly tight bras or constrictive clothing, and be careful when wearing baby carriers or carrying heavy bags that press heavily against your chest and upper arms. Some women find that they can reduce their risk of plugged ducts by sleeping on their sides or backs instead of on their stomachs. Nipple shields used inappropriately or unnecessarily can contribute to your risk. Also, be aware that it is not necessary to press down on the breast underneath your baby’s nose to help him breathe, and this misguided practice may lead to a plugged duct. Be careful not to nurse while lying on a bunched-up shirt, as this too can cause compression.
If you experience problems with your baby’s latch postpartum, it is important to remedy them as soon as possible by seeing a professional lactation consultant, preferably someone who has undergone the rigorous training of an IBCLC (International Board Certified Lactation Consultant) program, as these consultants have a wealth of practical breastfeeding knowledge. Poor latch can lead to plugged ducts and engorgement for you and inadequate nutrition for your baby, so improving it is key to successful breastfeeding.
Be aware that plugged ducts may result from excessive repetitive upper arm exercises, and that holidays and stress are also risk factors. The importance of taking care of yourself, drinking adequate fluids, and getting enough rest cannot be overemphasized for preventing plugged ducts, and for staving off mastitis when plugged ducts do occur.
If your nursing schedule is thrown off because of your baby’s refusal to nurse, leaving you engorged and uncomfortable, pump or hand-express just enough milk to make you comfortable. Alternately, you can wait until your baby is asleep and offer the breast again. He may take it while he is sleeping. Though you needn’t empty your breasts completely if your baby isn’t interested, avoiding an uncomfortable level of fullness can prevent plugs.