Tina said:"The problem is mom had breast surgery 18 months ago.  She found
a lump in one
breast and had it removed.  The incision is at the areola and her surgeon
told her that he was certain some of the ducts were cut and isn't
optimistic
about the ability of that breast to deliver the goods.  Mom has been told
by
both her OB and the surgeon that she will develop mastitis and will have to
stop breastfeeding because of that.  I have referred her to a LC to answer
specific problems as they come up, but I want to know if the advice she
received is incorrect.  If the breast is blocked from delivering milk to
the
baby, will that side stop producing milk with no suckling?  How likely is
she
to develop mastitis?"

I'm not a physician and hopefully you'll get a response from others, too.
 However I have some personal and academic knowledge related to this so
I'll  throw it in for what it's worth.  I had a lump removed after my first
child weaned.  I've nursed two kids since then and they've both gained
fine.  The incision was made at the areola and at least one duct was
removed on me.  That breast does make less milk, but still produces and the
other makes plenty.  We have lots of ducts in each breast so I don't see
why cutting some would make it not produce at all.  Or why it would "block"
milk from getting out. Or why it would cause later mastitis.  If there are
existing ducts that are blocked that would be one thing, but to have fewer
ducts wouldn't seem like it would cause infection. As I remember it (I
can't find references at the moment) when incisions are made around the
areola (done for cosmetic reasons) there is a risk of causing damage that
could interfere with MER because of damage to nerves. It depends on how big
and where the incision  is whether this happens.  Even if she couldn't feed
from that breast, she might be able to breastfeed completely from the other
one (just look back at all of the discussion of oversupply!).

Lucy Towbin, MSW,IBCLC

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