Hello all!


Anyone still remember my question about a mother who have had a
breast reduction operation and low milk supply and a persistent
fissure? Nobody answered but we are more sure now that this is
one of those rare situations when bf really doesnt work out.

The baby (seven weeks) grows beautifully now with supplementation.
If you remember, the baby hasnt reached his birth weight in three
weeks with exclusive bf. The mother doesnt want to try a nursing
supplementer. The breast with a fissure is still the same despite
of antibiotics. The mother stopped nursing from that side and
there is very little milk when she express milk from that side.
The doctors hopefully do the ultrasound in the near future to
see if there is an abscess or something else wrong in that breast.

The baby gets almost all of his milk from the bottle since the milk
supply seems very low, only 10-15% of the milk comes from the
healthy breast. I had to tell the mother that there is nothing
more she can do to increase her milk. It seems that too much
breast tissue was removed in the reduction operation and since
the nipples were removed and repositioned the ducts were cut,
too. In WHO´s document of "Mastitis, cause and management" is
said that recurrent mastitis may be due of ductal abnormality.
I think that this persistent nipple fissure may have something
to do with cut ducts, too.

The mother is going to bf as long as it feels good. Her goal is
realistic, she hopes to bf untill her son is two months old.
(She has three very young children.)

This was very hard for me, too. To tell a mother that I dont
think she can do anything more she has tried during these past
weeks to improve the situation.


Pia Ruohotie
Mother of two daughters, RN, mother-to-mother bf support group
leader from Helsinki, Finland (Europe)

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