At 08:21 PM 8/6/98 EDT, you wrote:
>I am assisting a 36 yo primip who had breast reduction surgery 8 years ago.
>She is producing milk, but each breast has several small lumpy areas behind
>the areolae.  The breast is generally soft.  She is able to express 1 to 1/2
>ounces when pumping.
>What would the consequences be of 'traditional' techniques to increase milk
>production?  If she pumps more frequently, would that lead to more lumps and
>discomfort?   Would fenugreek be worth trying?  Thanks.

I would certainly try to increase her supply with herbs (Blessed Thistle
and fenugreek, at least) and pumping. Any ducts that don't have an outlet
will stop "flowing" and will no longer create "lumps."

I have a story in the Archives about breastfeeding after breast-reduction
surgery.(Miralcles and Milk Flow, with the word miracles misspelled, so you
will need to search for it that way.) Only the mom's doubts (and an
unsupportive spouse) interfered with a full milk supply.  By the time the
baby was 5 months old, mom was producing much more than her newborn baby
would have needed to be fully breastfed. She learned that with subsequent
babies she can make enough milk. She went on to feed her baby past 18
months, which is the last time I heard from her.

At the newborn period everyone except her LC was telling her that she
couldn't make enough milk, and if she did it couldn't come out because her
nipple was re-placed. It is not known if your client can make enough milk,
but breast reduction surgery doesn't preclude a full milk supply.

Patricia Gima, IBCLC
Milwaukee


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