Ngozi's right breast was red, hard, and burning when she came in with her six-week-old baby. She had been told to stop breastfeeding. Mascot Healthcare treated her mastitis — and helped her keep breastfeeding.
Stay-at-home mother, Bariga. Presented 6 weeks postpartum with a 3-day history of right breast pain, redness, hardness, and fever of 39.1 °C. Ultrasound showed a 2 cm early abscess. Exclusively breastfeeding.
Lactational Mastitis (progressing to early abscess)Ngozi noticed the soreness on day 3 postpartum and attributed it to engorgement. By week 6, the right breast had developed a hard, hot, red area. She ran a fever of 39 °C overnight. Her mother-in-law — echoing advice she had received a generation earlier — told her: "Stop feeding from that breast immediately."
Her community health worker neighbour was more current: "Go to a clinic. And don't stop breastfeeding unless they tell you to — the milk draining keeps it from getting worse." Ngozi came to Mascot Healthcare the next morning with her baby.
The doctor examined the breast. There was a hard, fluctuant 2 cm area in the inflamed quadrant. An ultrasound was ordered immediately.
Lactational mastitis is a common breastfeeding complication. Without prompt treatment, it can progress to a breast abscess requiring drainage. Importantly, breastfeeding should usually continue.
A wedge-shaped area of redness on the upper outer right breast — warm to touch, progressively worsening.
Intense pain, worse on feeding and touching — making breastfeeding extremely difficult.
A hard, tender lump in the inflamed quadrant — suggesting either blocked duct or early abscess.
Systemic infection response — Ngozi was shivering and unable to get up comfortably.
Felt like the worst flu of her life — while trying to care for a newborn.
Warm compresses — appropriate for early mastitis; had not prevented progression.
Continued breastfeeding and pumping — correct management; helped maintain some drainage.
Paracetamol 1 g QDS — partial fever and pain control.
Told to stop breastfeeding by family — this advice was declined appropriately.
Ultrasound confirmed a 2 cm hypoechoic collection in the right breast consistent with an early abscess. Given the small size, aspiration under ultrasound guidance was performed rather than surgical incision — a less invasive approach that preserved the breast architecture and breastfeeding ability.
5 mL of pus was aspirated. A swab was sent for culture (it grew Staphylococcus aureus). Ngozi was prescribed a course of oral medication. She was advised to continue breastfeeding on both sides, apply warm compresses before feeds, and express after feeding from the affected breast.
Repeat ultrasound at 5 days showed complete resolution of the abscess cavity.
Lactational Mastitis progressing to early right breast abscess (2 cm — Staph aureus; ultrasound-guided aspiration)
Ultrasound-guided abscess aspiration; a course of oral medication; continue breastfeeding; warm compresses; repeat ultrasound at 5 days
Abscess resolved at 5-day repeat scan. Fever cleared within 48 hours of antibiotics. Ngozi continued exclusive breastfeeding.
Abscess completely resolved. Ngozi continued breastfeeding through the treatment and beyond — no cessation required. She is still breastfeeding at 4 months postpartum.
Mastitis in breastfeeding mothers should be treated promptly with antibiotics. Stopping breastfeeding is not usually necessary — in fact it often makes things worse. Early diagnosis prevents progression to a large abscess requiring surgical drainage.
Ultrasound-guided aspiration of small abscesses is a minimally invasive alternative to surgical incision — preserving the breast and maintaining breastfeeding capacity.
Mastitis needs antibiotics quickly — not stopped breastfeeding. Come in early and you can avoid the knife.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.