Two moms post carcinoma of the breast:
D. had a lumpectomy in the affected breast and radiation. The baby breastfed
from the beginning well, BUT her milk supply  was alarmingly late in coming
in (anxiety?).  I referred her to a colleague who works privately, and  we
used an SNS for a few days because the baby had lost to much weight. By day
7, we were able to discontinue the SNS and she is now happily breastfeeding
on the one side. Her thrill of breastfeeding seems to have erased all fears
and results of her past experience with the breast cancer.  There were no
problems on the breast that had undergone lumpectomy.
R. had a mastectomy on the affected side and breast augmentation on the
healthy side.  from the beginning she had a copious milk supply, and the
breastfeeding went well in the hospital.  I got a call from her mother last
week. she apparently had the beginnings of a breast infection.  It turns out
that once she got home , the family members managed to convince her that she
could not possibly produce enough milk from one breast, and  when the baby
seemed to be feeding more than every 4 hours, they suggested that she start
supplementing............I explained 10 times that you don't need two
breasts to feed one baby ( look at Jessica's quad story!!), but eventually
the family becomes the central authority.
I explained this yet again to the perplexed grandmother, who insisted that
"not enough milk" was a family problem.  I have a feeling that  R. will not
breastfeed for long.  OH well, win some lose some.

Jerusalem tragedy: happy ending.
Hanni, the mom who was injured in the terrorist attack, is now one month
post trauma and has had two additional operations to remove yet more
shrapnel and bullets from the affected breast. These explosive belts contain
metal pipes full of bullets and nails  which,  when the belt explodes, sends
thousands of bullets flying in all directions.  She has returned home to her
mother's house so they went to a different hospital, and of course the
doctors there said to stop breastfeeding.  At the time of surgery, she would
agree, and then after the pain subsided slightly, she would go home and
continue feeding Shoshi.  The milk on the affected side has a metallic taste
( the breast is still full of shrapnel) and Shoshi prefers the healthier
breast.  IN any case, she has gone back to full breastfeeding with an
occasional feed from her aunt when she comes to visit.
 I saw Shoshi yesterday when she came to my hospital to check the gash in
her shoulder which was not healing well. She has some really bad scars on
her wrist, and apparently her hand had been quite lacerated, but is now
healed with no sign.  .   Two of Bracha's daughters brought her to Tel Aviv,
and they told me something really interesting.  Shoshi kept licking the
wounds in her hands and wrist, and they healed before the others!!
In any case, she is a happy smiley six-month old who showed no signs of
stress at being in a hospital,  willingly came to me and put her sweet head
on my shoulder.  If you did not see the remaining marks on her face and
arms, you would not know that this baby had been through such a horrible
near-death experience .  She still has the famous green pacifier which saved
her life ( prevented her from lung damage from smoke inhalation and
protected the area around her mouth and lips........maybe we should all suck
on a huge green pacifier when we board buses in Israel?)  I took a picture
of her ( to compare to the horrible one right after the incident) and I will
tell the whole story in my presentation in the Rochester conference next
week.
This week would have been the third birthday of  Tehilla, Shoshi's sister
who was killed in the explosion, and Bracha has set up a free pump rental
system in her memory for mothers who are,  for whatever reason,  unable to
breastfeed and have to pump for their babies.   We also are hoping to
institute courses in the medical school to teach doctors about the anatomy
of the human lactation breast, which seems to be lacking in their education
up to now.  The courses will be named in memory of Tehilla and maybe some of
you will be invited to lecture in these courses!!
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel



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