Brenda,

If it is true that she "successfully breastfeed her other three kids with
absolutely no problems, due to the excellent technique of her surgeon," then
i would think she could do the same on the 4th lactation. I would first
investigate her definition of 'successful' to see if she supplemented the
babies at all, when did her milk come in, how much pumping did she do, if
any, galactagogues, engorgement, etc. Of course, anything is possible,
related to scar tissue etc, but very unlikely.

Therefore, I would investigate other reasons for failure of lactogenesis
such as retained placenta, endocrine issues, anemia (i.e. maternal factors)
and also possible contribution of infant to low milk supply such as tongue
tie, receding chin, palate anatomy, prematurity or near term baby, etc. Was
the pregnancy/birth very different from the others, such as C/S birth
diabetes, pregnancy induced hypertension, any other medical problems
(realize mom is older now for this baby, how much older? with new
intervening medical problems?)?

One week is still not too far out and the milk may come in soon. Hope this
helps you sort things out.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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