Thank you very much Chrisina.   I thought nerve damage was the problem and I am glad to see that is validated.   She is happily producing as much milk as she can and has stopped feeling like a "failure."    Eileen
On 2011-03-22, at 1:34 PM, hris wrote:

> Hi Eileen,
> 
> my colleagues and me are currently working with a mom who had heart surgery to 
> repair a PDA when she was 3 years old . It was done on her back, not on the 
> front - and she has marked breast asymmetry and the baby is gaining slowly (it 
> is her second baby and it was the same with her first). Milk is very low from 
> the affected breast. Interestingly, her aunt had the same surgery with the same 
> impact on breast growth and milk production. So it is not uncommon for heart 
> surgery to affect the breast - if there is some nerve damage to the 4th 
> intercostal nerve it can have an impact on the nipple sensitivity and on the 
> milk production too (in case of our mother it had an impact on breast 
> development too).
> 
> Although not quite fitting your situation, here is a citation that could be of 
> use - it is from the book "Management of Breast Diseases",Ismail Jatoi, Manfred 
> Kaufmann © Springer-Verlag Berlin Heidelberg 2010:
> 
> "Breast and pectoral muscle maldevelopment have
> been reported in children who have undergone anterolateral
> and posterolateral surgical incisions though the
> fourth intercostal space, an approach used for congenital
> heart surgery [93] . Anterolateral thoracostomies resulted
> in 60% of the patients subsequently having a greater than
> 20% discrepancy in volume of the breast and pectoral
> muscles on the ipsilateral and unaffected sides as reported
> in a retrospective study from the Children’s Hospital of
> Pittsburgh. Tube thoracostomy is one of the more common
> pediatric injuries, and results in scar and fi brous tissue
> tethering the breast to the chest wall [22] ."
> 
> Chrisina Yaneva
> National Association for BF Support
> Bulgaria
> 
> 
> ----- Original Message ----
> From: Eileen Ahearn-Shea <[log in to unmask]>
> To: [log in to unmask]
> Sent: Tue, March 22, 2011 3:36:41 PM
> Subject: mother with open heart surgery
> 
> I have a first time mother who had open heart surgery in her early
> twenties, about ten years ago.    She has no risk factos that I can
> find for lack of milk yet she produces less than 250 ml ( 8 ounces) per
> day.  Has anyone else ever run into this?   She does have some reduced
> sensation in her nipples.   Eileen
> 
> Eileen Ahearn Shea, BSc, IBCLC
> Clinical Lecturer, Family Health Team
> Department of Family Medicine
> McMaster University Faculty of Medicine
> 
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