Hi Celine and all,
I have had amazing breast reduction clients, who have taught me everything I
know about the topic, which is how things usually work!!!

Reading about the asymmetry to begin with would usually give warning signs.
What is good here, is that she was able to produce a few ounces with
pumping. This would tell me that she should be able to provide adequate
supply for the first few weeks, I would wager. It is really important that
she know that it is imperitive for her to follow the baby's cues, with no
invtervention such as dummies, bottles, etc.... and as this isn't a first
baby this isn't as easy to do for her with another little one at home.

With adequate and close followup, baby's weights and output checked, this
should build her confidence that she can do this. If all the vitals signs
are good, then she can proceed until the time where things MIGHT change. 

With reductions, I have found that the lack of confidence is the key here. 
She actually has one breast which was not operated on. And if she produced
milk there in the past, there is no reason that she might not be able to
breastfeed exclusively. I have had two cases of bilateral breast reductions
that breastfed exclusively well into the second year and still going
strong!!!

Close attention to weight gain and output and overall well-being of baby.

Good luck!!
Ellen Shein, IBCLC, LLLI
Tel aviv

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