I'm working with a mom who had breast reduction surgery ten years ago. At
the time, surgeon told her it was a 50/50 chance she'd be able to
breastfeed. Baby boy born by c/sec, 4/30, 8 lbs, 4 ozs. She reports "some"
sensation in her nipples. Mom expressed blood clots from one breast on
sunday. Nipples had blood blisters and were cracking. TAlked her through
better positioning and nipples are healing and not hurting during nursing
anymore. She was willing to talk, not be "seen" quite yet. She had not told
the baby's MD that she had breast reduction and wasn't scheduled for a baby
check for 2 weeks. I suggested she get the baby weighed at the hospital
Monday. Discharge (Sunday)weight was 7 lbs. 14 ozs.

Baby's weight was down a pound from birth weight (7 lbs. 4 ozs) yesterday
on the hospital's scales. At MD's office today, (admittedly, different
scale) down to 6 lbs., 14 ozs. She saw milk today for the first time(day 5
pp), this afternoon just before going to phys. Also, baby had first
change-over from meconium poop this afternoon. He is having 5 wet diapers a
day. Scant bowel movements until this afternoon. MD is NOT worried. Says
all is fine, Don't come back for weight check till Thursday.

Although Mom is obviously making some milk at last, this sounds like a
possible "situation". Baby is down 1 lb, 6 ozs. Mom says she hears only a
few swallows during a feed. I don't want to undermine mom's confidence, and
I don't want the MD to abandon breastfeeding. But, it seems to me that "ALL
is fine" is not how I'd describe this. Perhaps MD doesn't either, but
didn't want to alarm/disappoint mom.

In order to be brief, let me just say that I've covered the wide range of
possibilities with mom and given her lots of encouragement and praise.

What do y'all think? Latch improved Sunday night. If it hadn't been
stimulating her nipples enough when shallow, that would explain a lot. Her
milk obviously just came in today, am I being overly worried? I'm hoping
y'all will say....

"All is fine" sounds fine to you!!! And, that you wish your area baby docs
were as laid back as this one!

Thanks,
Margaret Ann

Margaret Ann Paxton, BA, IBCLC, LLLL
Virginia, USA