The surgery described certainly is cause for concern.  The human
body is amazing, however.  I know of one case where baby did fine in
spite of this type of reduction (as opposed to the pedicle one where
an intact nipple and underlying tissue is moved up in a "keyhole"
incision with fatty and some ductle tissue removed).    The only
explanation is that there is either spontaneous reconnection of some
of the severed ducts or regeneration of them.  I also know of others
where baby would up getting nothing from the brests and still others
who were able to get some of their milk to baby.  I think the best
approach is for her to start out giving baby the breast.  She needs
to be aware that there is no certain way to know the outcome until
she tries.  She needs to realize that there is the real possibliity
that she won't be able to get milk to her baby.  She may still feel
milk production occuring, but with no connection "to the outside
world" she will need to cope for a few days just like a mom that
doesn't breastfeed.  It is of critical importance to have frequent
close follow-up in the first few days looking for signs of milk
transfer, baby's output and weight status.  If this mom really wants
to nurse, of course, using the SNS or Lact-Aid will let her feed her
baby AT the breast if not BY the breast if she is not transferring
an adequate supply to baby.
Winnie Mading

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