Dear Lactnetters,

I work in a community health setting. A lot of our clients are
teens. I was given a sad breastfeeding consult by our doctor
yesterday.  I did not have a satisfactory answer, and told the
doctor I would query my friends on the lactnet to see what you
thought.

Kim, age 16 was in a car crash 7 weeks ago.  She was at 36 weeks
gestation. An emergency C/S was done, but the baby did not
survive. In fact it is speculated that the baby had died in the
crash, and the "fetal" heart tones heard were the mother's.  Kim
was in ICU for two weeks, had several surgeries on her hip, as
well as her spleen was removed.  She had been wearing a seatbelt.
She was on the passenger side and they were broadsided on her
side.

Today she is back at the maternity center for her PP checkup. She
is sad, depressed, and feels suicidal at times, but stated she is
too scared to attempt.  She is recieving little or no support at
this time.  Father of child (FOC) is a seasonal worker, speaks
little English, and whenever the subject is brought up, changes
it.  She has not attended any support groups.  She is tearful,
and appears relieved to be able to talk.  Social worker consult
for services and therapy and support group made. She declined
offer to have us call and set up appointment for her.  Said she
would call herself.  Social worker said she would call Kim in a
week, for follow up.

I related the full story because I think there is a connection
between this and my consult:
Her LMP (last menstrual period) was October.  Her first contact
with the Maternity Center was March 29.  In reviewing her
Physical examintion that was performed at that time, breasts were
symmetrical.
Right breast is significantly smaller than Left breast.
Impact from Accident was on the right side.
Left breast is engorged and leaking.  Right breast not lactating.
Left breast is very uncomfortable.

The question is: Why?  Could the accident have somehow affected
the right breast.  And/or in the process of her grief, milk is
being produced in one breast?

Any ideas?

Jane Squires