Dear Anne and Friends,

I have worked with many women who had a lumpectomy an breastfed with no problem.
This past year, however, I did have 2 mothers with some problems to think about.
Mother A had had 2 children before her surgery.  She was an over producer and
each time required a breast pump until she and the baby were working together
(5-8 oz. after breastfeedings to start).  She found a lump at the same time she
found out she was pregnant with #3.  She should never have had the surgery but
that is another story.  When her milk came in, she became painfully engorged in
the area that was cut.  We tried alternating hot and cold to reduce the area as
quickly as we could.  We pumped as we had done in the past.  That breast
produced less but we needed to reduce the engorgement so the baby could latch.
She did get an infection that required antibiotics.  She did not need surgery to
drain the area.  It finally involute and she breastfed well.

Mother B was a new patient.  She had a small incision on the right breast
9:00-12:00 about 1-11/2 in from the areola.  She was very engorged on that
breast.  The baby fed well off the L breast but could only get about 10 c.c.s.
from the R.  She was sent to my favorite surgeon to help answer her questions
about her surgery.  She did not know anything about her surgery and had a lot of
anger about not being told how it would affect breastfeeding.  She did get an
infection that needed medication.  She blamed me for causing the infection
because I encouraged her to keep breastfeeding and pumping on that side to bring
in the best amount of milk.  It turned out the the surgeon used an angle cut and
over 1/2 if the collecting sinus were cut.  She weaned.  The surgeon felt that I
did the right thing, but I think it might have been better to let that breast
involute.  It sure would have helped to have her surgical records before the
baby was born.

Good luck,
Diane Herforth, IBCLC