Dear Fiona:  It is difficult to tell the long term effects on lactation
in this woman's traumatized breast; probably too early to tell.  Some
factors which may influence subsequent lactation would include the
location of the incision, which could affect the number of ducts severed
(I'm willing to bet that the surgeon made the incision across the ducts
rather than along the length of them) and possibly the nerve supply (if
this was by a seat belt, I assume the hematoma was in an inner quadrant,
therefore unlikely to cause significant nerve damage).  Even if some
ducts are severed, she may well be able to continue nursing.  Marianne
Neifert gave a talk at the 1993 LLL/AAP Physicians' Seminar about the
effects of breast surgery on lactation, and mentioned that women have had
healing of incisions in their breasts even when milk was leaking out of
them.  She reported rare milk fistulas which heal spontaneously despite
continued nursing, provided adequate drainage is established.  So unless
the incision is right on the areola precluding nursing, it sounds like
she could continue.  Another alternative is unilateral nursing, allowing
for involution of the affected breast.  Hope this helps.  Alicia.
[log in to unmask]  P.S. The reference cited by Neifert was Barker P.  Milk
fistula:  An unusual complication of breast biopsy.  J R Coll Surge Edinb
1988;33:106.