Hi,

I just got a call from a mother. I wonder if you counselors out there who
have dealt a lot with mothers who have had breast reductions would respond
to the my questions at the end of this note. I've not had more than one or
two mothers who had breast reduction operations over that past 15 years or
so and thus I would appreciate your suggestions.

Mother is 37 years old. She was told by her doctors when she had her breasts
reduced at age 16 and 21 that she would never be able to nurse and therefore
she should not even try. They took a pound of breast tissue out and both
nipples were totally removed and replaced. The first operation was a partial
reduction and the second was a full reduction. Despite these reductions,
today she still has huge breasts. Her husband refers to them as melons.

She decided to try and nurse this child because with an earlier child her
milk gushed out at around the time of her son's bris and she wondered if
maybe with the following one she just might.

So she did with child number three. The baby was born at 3200 grams by CS.
He dropped down to 2300 in the hospital and now after three weeks of fully
breastfeeding, a two hour schedule with 30-45 minutes every feed, the baby
did not gain back any weight. She said that she is nursing all the time non
stop. Another Leader went over all the usual information given when there is
no or slow weight gain.

The baby is very sleepy and the mother is very bother by this. She feels
that she can't wake the baby up.

The baby was seen today by a doctor and tomorrow she is going to the well
baby clinic to be weighed before and after a feed. I suspect that tomorrow
the baby will start to receive supplements. I have suggested using the SNS
supplementer, cup, or spoon, or finger feed methods. Mother sounds very
happy with ideas in regards to supplementing which would not work against a
continuation of breastfeeding even if only partial.

Some added comments by the mother:

Mother, by chance, had to express in the hospital during the fist days due
to a 24 hour ceasing of nursing to help the bilirubin (sp?) go down. At one
session, she expressed 40-50 cc.

Mother feels that her breasts fill up and that she feels the sensation of
let downs. She has not had any breast infections or clogged ducts. She feels
that her breast fill and empty.

Given all this, my questions are

1. Is there any chance that mother could totally nurse? Is the obvious
really the obvious? That with all the reduction and cutting of the nerves
and ducts that her breasts simply can't produce and get enough milk to her
little one. Could there be other things that could be done to increase her
production of milk? What is amazing is the amount of milk that she expressed
in one sitting during the early days in the hospital. And that she has had
no breast infections or clogged ducts.

2. What would be the best way for the mother in this situation to supplement
her child and yet carry on with a positive, nurturing, and rewarding
breastfeeding experience.

Please respond privately to my e-mail address since I am not able to right
now read LACTNETS.

Thank you very much.

Devorah
LLLeader, APL Israel