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Date: | Sun, 9 Mar 2003 15:01:09 EST |
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In a message dated 3.9.03 12:05:38 AM, [log in to unmask] writes:
> Kate asks:
> "How is this possible? My understanding is that the
> nipple is picked up and moved to a new location
> without necessarily being near the ducts. I thought
> this was the surgery that led to "the milk won't come
> out", (in the words of a mom who had a reduction
> decided that it was hopeless by a week postpartum) as
> in, milk was produced but there was no way that any
> milk made it's way to the nipple."
>
> This had been my impression also, but I have read some cases where
> miraculously, the mom was able not only to make, but to deliver milk
> to her baby!
>
I am working with a mother now with a similar scenario and could use some
insight.
Although she didn't have a reduction she has bilateral areolar incisions,
partially encircling her very small areolas that look very much like the
periareolar incision lines characteristic of reduction surgeries. The
difference is that the incisions were made for the removal of cysts. Having
only seen cyst removal scars further back on the breast, this surprised me.
The surgeries were done *many* years ago but Mom is experiencing production
and milk removal issues similar to those of Moms post reduction. Production
on the left side is better but removal is mininal despite improvements over
the course of 2 visits, much massage,position change etc. Mom is also
pumping very little amts. despite persisiting full feeling on the left side.
Mom is supplementing and we have discussed the fact that she may never
exculsively nurse BUT I also emphasized the idea that the breast is dynamic
in it's ability to lactate and stopped just short of suggesting that breast
could continue to *repair* itself by creating the needed paths for milk
removal. I know that the thought is that by virtue of time the breast heals
and tries to return to it's intended state but is there anything to suggest
that the actual process of lactation is therapeutic in this sense ? Has all
of the repair happened prior to breastfeeding or is there suggestion that the
breast is continuing to grow new paths to milk removal by virtue of
lactogenesis?
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts
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