Mary Kay writes: <Seems that I've had a run of moms with implants in the
last few days and I'm looking for an appropriate handout for them
regarding nursing with implants. Most of them don't even realize that
lactation could be affected. . I try to emphasize good management and how
to treat engorgement> I agree with Mary Kay's emphasis. But I have
wondered at times if we ourselves as professionals all realize this basic
fact. 


The breast augmentations that we see in new mothers are less likely to
have been done for cancer than because the mother perceived herself to be
too small a size/unusual shape in comparison with other women. In at
least some instances, that small size or unusual shape alone might be an
indication of insufficient glandular tissue. 


Therefore, risk of supply issues could have been a reality before the
location of any incisions affecting nerves, prolactin and oxytocin
stimulation, etc. It's probably a good idea when taking a history to
tactfully ask the reason she had the surgery in the first place, to
better guide the teaching, and the post birth observation of the mother
as well as the baby's weight gain. Just musing.


Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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