>I just talked with a who mother had breast reduction surgery in
>1987.  <snip> Could the surgery itself be responsible in any way?  This is
>a woman who could probably produce at least half her baby's needs (based
>on her first lactation), and who is more than willing to use an SNS.  But
>she can't get rid of the pain and bleeding.

Hi, Diane,

In response to the case you present above, it does not seem to me that the
cause of this mothers' sore nipples and mastitis could be the
surgery.  This seems to me to be a "zebra" case -- one in which normal
issues of latching/positioning/suckling must be addressed (which I know you
will quite competently do).  Reduction surgery can rarely cause subdermal
areolar and ductal adhesions, but the pain that typically results is not
consistent with what you describe.

By way of supplementation and increasing her milk supply, she may find that
using a Lact-Aid will maximize her milk supply better than the SNS.  She
may also be a candidate for domperidone.

Diana West, LLLL, IBCLC candidate 2002
Managing Director, BFAR
http://www.bfar.org

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