I have a mother who just delivered a 34 weeker. (She gave me permission to
post this question.) She had breast reduction surgery in 2000.  They did
the technique where the nipple is not removed and reattached.  (I believe
it's called the peduncle technique).
Baby is doing OK, but is currently NPO because of some respiratory
distress.

A friend of mine attended the La Leche League Conference in SanFrancisco
last summer and told me about Kitty Franz's presentation.  She told me that
Kitty had some pretty impressive slides taken of women who'd had reductions
and then had suffered hemorrhages in their breasts from the pressure of
pumping.  She gave me her notes where she had written "no pumping after
reduction".

If the baby's respiratory rate improves, the pediatrician is OK with
letting him breastfeed ad lib.  In the meantime, I'm wondering how I should
manage this mother.

I know she should have stimulation to get her supply going, but I don't
want to put her at risk by having her pump.

Did anyone hear that talk?  Is hand expression safer in this situation?
What about when her "milk is in" and her breasts are fuller?  Is pumping
less of a concern then?

Thanks in advance for any suggestions!

Barb Fibich, RN, IBCLC
Milwaukee, WI

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