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 *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html