Cathy writes;
>>When women wean, the milk producing cells go through a process called
apoptosis. This is where the cells are programmed (as involution or weaning
occurs) to die a natural death without initial loss of structural integrity=
.
This is followed by degradation of the extra cellular matrix and eventually
almost all of the mammary epithelium is reabsorbed. <<

Cathy this is fascinating stuff. I'm wondering if it applies at all to a
situation that I encountered recently. As a VNA nurse/LC I was seeing a 9days
postpartum c/s Mom with a wound infection. This was her fourth child and she
didn't intend to breastfd. as she hadn't attempted with any of her others.
After my little "speil" she decided to give it a try...I helped with latch,
she still had milk although the breasts were definitely well into involution,
the supply would need to be built up to sustain the baby. The baby latched
easily and fairly well, Mom nursed exculsively for 12 hrs. when the baby spit
up blood. She immediately removed the baby from the breast, husband was
"freaked out" that she had  attempted at all at this point......but since I
saw her again the next day for her wound, I examined the nipples-looked fine,
breasts were much fuller (she hadn't nursed at this point now for > 12hrs.)
watched the baby suckle- all looked fine so I encouraged her to try again and
unfortunately the same thing happened. She decided at that point to give up
entirely. Of course, I wasn't surprised BUT was and am curious about whether
the bleeding had anything to do with the involution/apoptosis process. We
know that many Moms return to nursing after a day or two break or stop and go
back for whatever reason but could this process have been unique in that she
had never nursed and was attempting at a point where her ducts/sinuses were
friable?
What do you think?
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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