37F, 5’10, 200lbs, almost 5 months postpartum. I am exclusively breastfeeding my third and final child. During this pregnancy I developed hyperthyroidism. PTU was titrated by MFM throughout pregnancy, then I was switched to methimazole by an endocrinologist when postpartum.

Current meds: prenatal, sunflower lecithin, inositol, ibuprofen. Methimazole dose is 2.5g every other day.

At 13 weeks pp I was engorged and uncomfortable but doing my best to empty clogged ducts and do all the old remedies that I had learned when nursing my older two children- dangle feeding, warm compresses, electric toothbrush, frequent emptying of breast. At week 15 the lump was worse and I called for a same day appt. I was certain it wasn’t mastitis as I didn’t have flu-like s/s. Kaiser appt center said I had to see my primary for this issue, so I saw an internal med doc who had an opening that day. She ordered an ultrasound at the breast center and told me to use alternating warm or cold compresses and ibuprofen for inflammation.

On 5/22 (17 wk pp) they did the ultrasound and appreciated a 10.7cm x8cm x 11.8 cm retroareolar fluid collection. Because of its size and my discomfort (my boob was so shiny and taut and I was waking up in the middle of the night from it), they offered me an FNA to drain it essentially then and there. The breast center doctor ended up removing over 500ml of milk. Afterwards my boob looked so crazy and deflated but it was finally comfortable and not a huge planet on my chest. I asked who I should follow up with and he said he would send a sample to the lab and the referring doctor would contact with results. I asked about seeing lactation and he said he had no advice one way or another (?!). He had me schedule a one-month recheck u/s. Gram stain and cultures were negative.

I took it upon myself to call lactation and she gave me advice to continue with sunflower lecithin and inositol and to feed my baby “intuitively” from either breast. She told me to use ice and ibuprofen to reduce inflammation.

By 5/29 I was already really uncomfortable and painfully full again but the KP breast center couldn’t see me. The initial referring office told me to go to urgent care. Urgent care said they don’t drain galactoceles, but ER might if they call in the IR doc. I declined because I felt like I wasn’t worth the trouble and just suffered through another week until the breast center could fit me in again. 

6/8 they did the ultrasound again and followed with FNA of about 740ml milk.  
I asked the doc if I could see a breast surgeon to have a drain placed and he said they don’t do that there. I asked what the long-term plan could be and he said he would just keep performing FNAs for me. I contacted the appt center and had a telemed appt today with a PA who wants to order labs to see why this is happening. I agreed but asked for the breast surgeon referral. I just got a message back saying the referral has been cancelled and to follow up with PCP or OB and that I should stop breastfeeding PERIOD. This feels so dismissive and final, and I am not ready to give up breastfeeding. We’ve been trying to give bottles of previously expressed milk, trialing three different nipples, and even formula (once). Baby is not down to stop cold turkey either, and that is causing me additional distress.

My question is- what can I realistically ask for? I want a second opinion, but am I being stubborn? I read an article from NLM where they placed a Penrose drain and the mom continued to BF until baby was over a year old. My other two children were breastfed until they were 2yo. I already called for another FNA for tomorrow because it’s full again. This is taking a toll on me. Please give me hope! 

I will try to post images but it’s my first time. Thank you!! 

Galactocele in BF mom. Please advise