While I have been lurking for a couple years, I have not posted for a while,
and I need to ask your collective advice. A client came to see me today and
has given permission for me to post to the list. Her baby is three days old.
She was latching at the breast the first day, but the baby had only 1 stool
in the hospital, so she was instructed to give formula. Since then, the baby
latches, but releases quickly and tires easily. Probably also gets frustrated
since the milk is not readily available as in the bottle. The baby also
looked slightly jaundiced today. At this point, the baby is offered the
breast, but is mostly formula fed. Has had only one more meconium stool
(Meconium stained amniotic fluid plus one small mec in hosp). Has sufficient
wet diapers.
Her history is that she has polyurethane coated silicone implants (Replicon
implants - the ones that were taken off the market). Because of difficulties,
she had reconstruction but elected to have the same type of implant. This was
13 years ago.  Her nipples have been removed and reattached. The main concern
is whether or not she be able to make sufficient milk and will this type of
implant cause problems with her baby. She quoted a study that said this
coating breaks down into TDA, a compound that can cause liver cancer in rats.
She knows that the silicone is not a concern.  She is frustrated because she
is going to all this trouble and if the baby will be "harmed from the milk
due to the implants" then she wonders if it is worth the effort. She is also
very exhausted.
Today the baby did latch, and did suck well, but did not maintain sucking for
any period of time. I did discuss using an sns at the breast, but she elected
to wait on that option. The use of a syringe at the breast did encourage the
baby to maintain the latch and nurse. I taught them finger feeding with the
syringe. We also used the classic pump and obtained about 1cc of colostrum
form one breast but only a few drops from the other. While her breasts are
warm, they did not feel any larger to her. We discussed the importance of
regular stimulation, whether it is the baby effectively nursing or using the
pump.  We also discussed the possibility that we will not know how much milk
will be available until her milk is in and she is either pumping or the baby
is nursing effectively.
I have searched the archives with no matches. Also, neither Lawrence or
Riordan address nursing with this type of implant in detail as it has been
off the market for many years.  I am hoping that someone can provide me with
info in regard to the safety of breastfeeding with Replicon implants.
I look forward to your collective wisdom.
Sincerely,
Linda Goldberg, RN, CCE, LC in training
Central Florida, USA

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