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Subject:
From:
Kathy Boggs <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 30 May 2003 18:57:21 EDT
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Brenda writes of fourth time mom who successfully breastfed 3 other children
after breast reduction surgery.Mom states she never felt her milk surge like
she did the
other three times. She did lose lots of blood at delivery, but no
transfusion was necessary. My question is, could this still be from the
breast reduction surgery,even though she was able to nurse her other three kids?
Could scar
tissue have built up, blocking her milk ducts?

The clue here is that mother never felt milk surge like she did with her
other 3 children. This seems to be a failure of lactogenesis 2 and not a result of
breast reduction surgery. Even if the ducts were scarred she would have noted
her breasts filling. She has proven with her last 3 children that she has
adequate glandular tissue to produce sufficient milk. I would look elsewhere for
an answer. Blood loss is certainly one factor. I know in our hospital hgb has
to be strikingly low before they consider a transfusion. It's also important
to look at the baby and evaluate his ability to breastfeed effectively.I would
check also for sx of retained placenta. I would treat her as any other mother
with low supply. Carefully evaluate milk transfer by baby, evaluate supply and
start her on a plan to provide adequate stimulation to the breasts with a
combination of baby and a hospital grade pump. Finally, of course, feed the baby.
Let us know what happens.

Kathy Boggs, RN, IBCLC
Mountain View, CA

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