Why does the women who has had bilateral breast augmentation surgery
twice have to stop breastfeeding, gradually or otherwise?  She
obviously needs treatment for her (presumably non-infective)
mastitis, but weaning won't help the lobes that have no ductal
openings. Continuing milk production is dependent on milk removal, so
they will eventually involute whether she breastfeeds or not, and she
can continue to feed with whatever lobes still have intact ducts.
If the baby is gaining well, she must have some functioning ducts.
It remains to be seen whether she will have an adequate supply and
whether she needs to supplement, now or later.

Some of these mothers seem to synthesise milk at maximum rates and
make enough milk while the baby is small, but cannot increase
production as the baby grows. If they are already producing at 100%
in the lobes that are intact, there is no room for an increase.  I
think that is why we sometimes see growth faltering after an initial
promising start - aAn indication for supplementing, not for weaning.

Breastfeeding in this situation (and most others) is not a do or
don't issue.  Can't we teach women to breastfeed as much as they can,
for as long as they can.  Sure, exclusive breastfeeding is the
ideal, but partial breastfeeding is the next best option.  This
limitation to a do/don't situation is something I feel strongly
about, and come across all too often. Climbing down.....

Ros Escott
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