From: [log in to unmask] <[log in to unmask]>
Date: Wednesday, July 05, 2000 2:28 PM
Subject: Breast Reduction Surgery

Lani
Working with dozens and dozens of mothers with breast redux --my experience
has been that the majority do not make enough milk for the babies especially
in the first two weeks.  She needs to be double pumping 8x a day( or more)
for two weeks before she will know if she has enough just for that mark,
after milk is in the baby weigh scale is a good tool to determine
ntake( after milk is in).  Some mothers with redux can make all the milk the
baby needs --most can only make so much and no more.
These mothers  should call or write  her breast surgeon (during the
pregnancy) to determine the extent of her surgery and what his /her record
is for mother's who have had his surgery and desire to provide breastmilk
for their babies.  Usually at the time of surgery they are not really
thinking this and they hear "Oh sure you can nurse a baby" and never really
persue it beyond that.. the procedure varies , although it is getting better
there is still a lot in the hands of the plastic surgeon.  Having the mother
call is a reality  check for her and maybe when these surgeons get enough
calls they will provide more adequate counseling ahead.    Had she discussed
this with the ped ahead to let them know that she had this surgery?  Not
fair to not let them know early on as they may r/o other reasons for the
hypoglycemia and order lab work that may not be needed.  Did she have the
plan to get a pump and start pumping soon after birth?
It's a shame that it wasn't handled better by ped but I can see how it
happened.   Once the blood sugar is down the baby might not have the stamina
to use the SNS for an efficient feed.  At that point frequent pumping might
be the best way to use her time .. then when she is with the baby she can do
what some mother's call "breast bonding"  with lots of skin to skin and
learning her infant's cues.  Does your hospital have a protocol for mother's
with hx of redux surgery ?  This would give basis for a proven plan and let
the 60ml following a BF attempt --be tempered .
Most women are very happy with redux surgery until it is time to lactate
then they get a lot of emotional entanglement that interferes with some of
the needs of the infant.  She must have felt good about the ability to be
able to "board" near her baby -- most facilities do not have that option.
Beadie Cambardella RN IBCLC
Northside Hospital 14,000 deliveries year
Atlanta , GA (home to many many plastic surgeons)
-----Original Message-----

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