Oh, can we do that...there are so many great breasts out there not
being used! Haha.  Forget the silicone and saline, lets get
functioning breasts!

If I work with a mom during pregnancy and birth, I always ask certain
questions that let me know to watch more carefully. Luckily I have not
had more than a handful where I knew ahead of time to watch closely.
The mom with the twins really must have lied to me.  I know that is
harsh, but there was no darkening of her areola, and I cannot imagine
she had any breast changes and that is always something I ask my doula
clients.  She said her breasts grew a cup size, but I don't see how
that was possible.  All I can think of is her desire to breastfeed and
her research gave her the right answers to my questions.  Knowing
other issues about her kept me from mentioning anything to her in the
hours after her babies were delivered.  But, I definitely spoke to the
nurse manager to be sure she was closely monitored and seen by the
hospital lactation staff immediately.

I have to say we are extremely lucky in my area.  We have great
lactation consultants at most of our hospitals and they are all
competent if not brilliant!  We have hospital policies in place at
most of our hospitals that promote breastfeeding to a decent extent.
Maybe not perfect all the time, but mostly good.  Birth is another
story, but baby steps I tell myself.

I will have to think more about your approach Cathy. Perhaps my own
fear of power of suggestion is interfering with my approach.
Augmentation issues are something I do discuss if I know during
pregnancy since mothers are already aware of the possible
complications. It seems so much easier if there is already an
awareness that complications may occur and I am not the first person
telling them.  I don't always see mothers during pregnancy so have not
had to face the situation often.  It is hard enough when I am sure
there is a problem.  Once I am seeing a mother for supply issues I do
exactly as you describe.

And now, I am envisioning a world where all implants have function....

Take care,
Pam MazzellaDiBosco, IBCLC, RLC


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