A few days ago there was a terrorist attack on a bus in Jerusalem.  Several
babies and young children were killed and many badly injured.
Yesterday I discovered that one of the children killed was the
three-year-old granddaughter of one of our IBCLC's, Bracha Toporovich.
Bacha's 26 year-old daughter Hannah and her family were on the bus on the
way back from a family prayer outing at the Western Wall.  Hanny was sitting
with her two younger children on her lap, three-year-old Tehilla, and
5-month old Shoshana.  Tehilla was asleep at the time of the blast and
probably did not feel anything before she died.  Shoshanna was found hours
later alive under some corpses, and is in stable condition.  Hanny suffered
from a shattered pelvis, and jaw, superficial facial wounds and deep
contusions in one breast, similar to GSW's.(the explosive devices emit
thousands of bullets which penetrate all bodies in proximity.) She is
breastfeeding ,of course, and wants her baby to get her milk.  The baby is
in a different hospital, and volunteers are delivering the milk to her
regularly.  She was getting the milk via NG tube, and as of this afternoon
has been taken off the resuscitator, and is improving greatly ( we all know
why).
Now the  breastfeeding problem: the injured breast is leaking milk.  Bacha
was pumping both of Hanny's breasts, at first,  but because the milk from
the injured side was brownish,   decided to dry up the injured breast, and
continue to pump the healthy breast to supply milk for Shoshi.  Pumping the
injured breast with an electric pump was too painful , so  Bracha has been
hand expressing gently from that side only when the breast becomes
uncomfortable ( that side never did produce much milk, according to Hanny).
Now, along comes the surgeon and wants the mother to stop breastfeeding
entirely so that the wounds will heal, and won't become infected.  Bracha
tried to explain that the breasts work independently, and that gradually
they will dry up the affected breast, and  will continue to pump from the
healthy  breast to supply milk for the baby and when possible,  eventually
go back to breastfeeding form that side.  The doctor insists that as long as
they are pumping from the healthy side, the injured breast will continue to
produce milk.   I have references to the contrary, but this particular
surgeon will not listen.  All of our breastfeeding friendly docs are out of
the country at this moment.  Just as I was speaking to Bracha, I heard in
the background that a ob-gyn was on his way downstairs, and said not to stop
breastfeeding!! He will check Hanny and decide.
Have any of you had experience with open wounds and wound healing in a
lactating breast? How long can we expect it to take until the lesions close?
I will let you know what happens.  It would be tragic to force this mother
who has just lost her child to stop breastfeeding, especially since the
surviving baby needs her milk to recover!!

BTW, one of the other survivors on the bus said that she was breastfeeding
her baby at the time of the blast. Both mother and baby had minor injuries.
Two other little girls gave up their seat to let a pregnant woman sit down.
The woman was killed and the little girls survived.
It has been such a sad day here.

Esther Grunis, IBCLC  (who wears normal clothes in the hospital, and no
longer wears a lab coat because everyone thought I was a doctor.)
Lis Maternity Hospital
Tel Aviv, Israel



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