A mother called me a couple of months ago to get my opinion of the possibility of her breastfeeding her baby after having had breast reduction surgery 14 years ago when she was 16. She described scars under her breasts and said that both areolas with nipple were removed and moved to another place on her breasts. I told her that I didn't know, but that I had worked with another mother who had had extensive surgery to create everted nipples from inverted ones and who had successfully lactated. I advised her to plan to breastfeed her baby. She delivered last week and immediately was able to express colostrom. The baby fed well, though her nipples were sore because, since the surgery, they have been extremely sensitive to the slightest touch. Baby was audibly swallowing. Her mature milk came in on day 4 and she was leaking from the side the baby wasn't feeding on. The sensitivity is lessening. She was so thrilled to see milk coming from her breasts. So was I! Isn't that truly miraculous? Her breasts look like a real butcher job--big scars from "3 oclock to 9 oclock" The areolas looked glued on. She had had much breast pain all through the years until a few years ago when she had some deep tissue body work to free some of the adhesions. I am assuming that with each menstrual period she had since she was 16, more milk-producing capacity was developed, and ducts were even re-routed to her nipples! Amazing! Her supply seemed below what her baby wanted so she began pumping. Dad had been around while I was working with her (I do home visits) and he was very detatched and disinterested. When she began pumping, a few ducts were spraying and she was getting a pretty good flow. She was so excited. Then Dad looked over and said, "All you need to do is Moo." She gave an embarrassed laugh and I commented that she is making human milk for their baby and doing a great job. He said that he grew up on a dairy farm and the pump sounded just like the pump for the cows 'cept they had four instead of two. Immediately the milk flow stopped. Not a drop would come. She suggested that I turn up the marker to med or high. I turned it gradually to med--still no milk. I suggested that she try later because perhaps her baby took most of the readily-available milk. As we were clearing the pump area it came to me what had happened. I had been so focused on the mother that I hadn't put it together at first. So while she went to change the baby I had a "talk" with Papa. I let him know that she needs him to be her cheer leader and to share in her joy that her body has healed to the place that she can make this great milk for their baby. I didn't mention what had just happened, but I made it clear that he has a responsibility in the health of their baby and that breastfeeding is "where it's at." When she returned he expressed enthusiasm for the diaper report and seemed to have become an alive person. He listened with interest to my recommendations. I left her some fenugreek capsules and the next morning she called to say that baby was swallowing much more--gulping even--and she was pumping a lot more. I've thought about her experience with her body--from rejection, poorly-done surgery, pain, healing body work, her breasts recovering from it all, her husband's derisive remarks, the stopped flow, his new encouragement matching her determination (even with sensitive nipples), and now she can have the joy of watching her baby girl grow on her milk. Wow! I predict that she will make a full milk supply. Almost everyone told her that she would either not make milk or, if she did, it wouldn't be able to get out. After she was seeing milk, people were saying that she would probably not be able to make enough. I told her to forget that she had had surgery (and to stop listening to people) and just look at all of that milk dripping all over her shirt! There is a lot in this story to ponder. How often is a milk supply affected by expectation--either of mother or others? Fathers need to learn what they can do to really help. Encouragement or discouragement can do so much. Severed milk ducts can be overcome if the fear of severed milk ducts can be overcome. If she hadn't had the healing body work would she have been able to do what she has? Someday I'm going to write a poem for all of the heroic women I have worked with these many years. Patricia Gima, IBCLC Milwaukee, where we had a "lovely" Easter snow! "In your Easter parka..." mailto:[log in to unmask]