On Fri, 9 Jun 2000 10:53:34 EDT, [log in to unmask] wrote:

>I had a very unusual case.  New mom delivered healthy baby at term natural
>childbirth.  Baby went to breast immediately.  Mom went home at 24 hours
post
>partum.  Baby nursed every 2-3 hours around the clock with good deep latch.
>At 4 days old, baby admitted to hospital with 12% weight loss and jaundice.
>Mom extremely engorged.  We immediately went to work on her engorgement and
>kept putting the baby to breast with SNS with formula.  Baby began gaining
>and mom's engorgement began to subside but no milk transfer taking place at
>the breast!  Mom had no medical condition that would contribute to problems
>with milk transfer or production.  No retained placenta.  No implants or
>breast reduction.  The mom DID have surgery on her nipples 15 years ago to
>make them everted.  They were extremely inverted at the time.  Incision was
>"L" shaped on base of areola and went from tip of her nipple down to areola
>and across.  This mom nursed with SNS and used Classic pump for 2 weeks and
>got milk out.  Only thing I could attribute this to was that somehow the
>surgery she had severed the ducts and/or scar tissue formation had formed
>around the ducts and not allowed milk to get out.  Mom finally decided to
>investigate the San Jose Mother's Milk Bank on my recommendation because
she
>wanted her newborn to have breastmilk over formula.  Her pediatrician
warned
>her it was not risk free, with AIDS and all, and that if it was HIS baby he
>would give formula.  I sent them both info on the bank and the process and
>talked with the pedi.  He asked me if I had told her there were NO risks
with
>banked milk.  I said to him TWICE that what I said was in the last 25 years
>there has been no incidence of infection from any of the banked milk given
>out.  I then said "Do you know how many times formula has been recalled in
>the last 10 years?"  "Did you discuss with her the risks for formula?"  He
>backed down.  Well, my question to all of you knowledgeable LC's is, why
>couldn't I get the mom's milk out?  Do you think it was because of the
>surgery?  I had mom using warm, moist compresses and manual expression too.
>NOT ONE DROP EVER SEEN.  Loni Denman, RN, IBCLC
>
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I had a similar patient last year with similar results. It just so happened
that I worked with her the week before the ILCA COnference last year &
someone brought up a similar situation in a breakout session. I believe it
was the session titled "The Impact of Breast Surgery on Breastfeeding and
Milk Production." I'm sure others of you were there, so correct me if I'm
wrong but one of the presenters was asked about their success with women who
had this procedure and they said they had seen several and none were
successful with being able to breastfeed. Someone, PLEASE correct me if I'm
wrong.
Julia in sunny Eden, NC

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