This from:
Carolyn Brown, La Leche League Leader, Cedar Falls, Iowa
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Subject: Mom w/reduction engorged
I have been helping a mom who had a breast reduction ~5
years ago - quite extensive, her nipples had to be moved.
She breastfed her first baby, now a year old, for about
three months, although the baby required extensive
supplementation. She now has a second child, born 30 March
98. This baby is being breastfed, with some supplementation
(I don't know proportions) via SNS and bottle.
Her immediate problem is painful engorgement, after she
slept for 7 hours last night (Dad bottle fed baby formula).
this is the first engorgement she's felt with this baby.
We are both wondering if engorgement will take longer to
subside, since many ductules were cut in the reduction
surgery. I suggested cold packs and Tylenol. Mom declined
Tylenol but felt this evening that cold was helping.
She has about 75% of the alveoli left - I believe
she could produce an adequate supply, but the
recanalization that has taken place is not enough to permit
all she could produce to get out. There seems to have been
more recanalization occurring with this second pregnancy - is
this normal?
Mom reports that baby's bowel movements are yellow and
mustardy in texture, and while he does get the bottle daily,
he goes between mom with supplementer and bottles well - so
far. Is this likely to continue? The older baby rejected
the breast, with or without SNS, at 3 months, right at
growth spurt time. Any predictions on whether this will
happen again?
Mom is taking many herbs, vitamins and nutritional
supplements, some as galactagogues, some for general
well-being. She is convinced they are helping. I am
somewhat skeptical. Opinions?
thanks for any input. I will check the archives, but it
seems to me that it's hard to generalize about breastfeeding
after reduction surgery, that cases vary greatly from
individual to individual.
Carolyn Brown, LLLL, Cedar Falls, Iowa, USA
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
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