I just met with a woman who had breast-reduction surgery 17 years ago and is
expecting her second child in a month or so.

Her first baby (born 3 years ago elsewhere) needed heavy supplementation and
stopped nursing at 3 months.  The mother continued to pump for another
month.  But here's the interesting part:  Her nipples were really sore as
long as she was nursing, she could see the corner of her baby's mouth when
the baby was at breast, and she was pumping 2 oz from each breast with a PNS
at 4 months.

I think it could very well be that ordinary positioning problems were
glossed over because of preconceptions about the effects of her surgery, and
we're proceeding with that expectation - preparing for the worst but hoping
very reasonably for the best.

In my earliest days, I tried to help a woman who had had a great deal of
chest irradiation for Hodgkin's lymphoma.  She'd been told it could affect
breast development, and indeed her baby Sally needed ongoing
supplementation.  But not long after, I went to a Kittie Frantz conference
at which Kittie called a slow-gaining baby up from the audience.  I nearly
gasped aloud.  "That's Sally!" I thought.  Of course it wasn't, but this
baby had the same low tone that I'd noticed in Sally all along and hadn't
had the experience to think anything of.

My guess is that, with each of these mothers, an atypical mother-issue
blinded caregivers to what were really run-of-the-mill baby-issues.  A
strong reminder that, even if we *see* a zebra when we hear hoofbeats, we
still need to look around for horses.
--
Diane Wiessinger, MS, IBCLC  Ithaca, NY back in town after a near-week away
www.wiessinger.baka.com

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