I think it is always prudent to keep an eye on production when women have
had major chest surgery.  There may be no impairment of lactation, or, some
of the important nerves may have been severed or damaged in ways that will
affect lactation.  I have a slide of a woman I worked with who had open
heart surgery as a teen.  She was able to achieve only partial lactation.

In terms of counseling (since we don't want to plant negative suggestions
that may be self-fulfilling) I say something like:  "Well, sometimes
invasive surgery has repurcussions, but the body's ability to heal is
remarkable.  Let's wait and see.  We will provide you with the best guidance
we can in the early postpartum, and let's follow your baby's weight
gain/output carefully until we see how things shake out." The mother then
feels well-supported and we have provided the information without either
discouraging her from trying or setting her up for a big, unexpected
disappointment by over-selling a positive outcome.  Of course you then MUST
follow-through with excellent management early on.


Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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