The mother, for whom I need help, is
28, received radiation therapy to her chest when she was treated for
Hodgkin's Disease twelve years ago.  She had tried to breastfeed her
first child, who is now five years old, with minimal success.

I've dealt with an IBCLC who was concerned that Hodgkin's and the radiation
treatment she received for it would mean that baby 2 could not be
breastfed. Baby 1 certainly was. Day five mother was desperately afraid she
had too little milk. I sent her to bed, carried baby in a sling for a few
hours, helped her get baby latched on well, went away. Of course mother
woke up with full breasts, a clear head, and a hungry baby (kept happy by
strenuous caregiver strategies) emptied them and it all went on from there.
Mother was still breastfeeding baby 2 when I needed a demonstration model
for medical students almost three years later. (Kid stole the show, of
course. Medical students astounded that anything with teeth and a varied
vocabulary actually breastfed. Hilarious class.)

Sample of one can't be the basis for generalisations, but I suspect that if
I had treated this as a special case with cause for concern, rather than
just another exhausted anxious day 5 mother, the results could have been
different. I emphasized the basic physiology: there is milk there; the kid
determines how much by removing it, and the emptier the breast the faster
the rate of synthesis; glandular tissue does grow in each pregnancy and
lactation; that whatever damage was done was a long time ago and (my
constant theme) lactation is a survival mechanism. Go to sleep and stop
worrying. (It seems to me that there are times when mothers need
directive-type mothering: one can hand back control when they are again in
control of themselves. A mother beside herself with fatigue and anxiety
can't think straight, so we need to deal with restoring her.)



Maureen Minchin, IBCLC
5 St, George's Rd., Armadale Vic 3143 Australia
tel/fax after March 1: 61.3.95094929 or 95000648