Claudia wrote about a mom whose breast is severly scarred by a long-ago
burn, with no intact nipple, and asks what to expect when the baby is born.

Claudia, you can figure this out from what you know about normal breast
function. Where she has intact glandular tissue in the affected breast, she
will start making milk (unless there is some other reason not to make
milk...hormonal, for instance). Then, in the places where the milk can't get
out--just as if the ducts had been severed and scarred by surgery--she will
have tender, hard swelling in the breast. Eventually, through feedback
inhibition (FIL), the glandular tissue will stop making milk, the milk will
be re-absorbed, and lactation will cease on that breast within a few days.

Meanwhile, if the other breast is undamaged from the burn, lactation and
breastfeeding should proceed in the normal way. She should nurse on the one
side, keep a careful eye on the baby's output and weight, and fend off any
"helpful" offers of supplementation from people who forget that twin and
supertwin mothers can make enough milk for multiple babies with two breasts,
so she has no reason to think she can't make enough for one baby with one
breast.

She can try applying cold compresses or cabbage leaves to the affected
breast while she waits for the pain and swelling to go away. (Although I
know there's no evidence that cabbage works, I think if it feels good
there's no reason NOT to do it.) She can take anti-inflammatory meds and
analgesics for comfort. She can gently massage lateral part of the affected
breast in the direction of her axila, which might possibly help lymphatic
drainage...but this should be done only with the lightest of fingertip
pressure.

Good luck to her!
Chris

Chris Mulford, RN, IBCLC
LLL Leader Reserve
Working for WIC in South Jersey (Eastern USA
Chair, Workplace Bf Support Committee, USBC
Co-coordinator, Women & Work Task Force, WABA
 
 

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