Donna Zitzelberger writes to share Nancy Hurst's new study on implants and
impairment of lactation.  I think Nancy's work does document something I see
fairly often -- and I agree with Neifert that any kind of breast surgery
increases the RISK that lactation may -- to one degree or another- - be
affected.  In Texas we see lots of augments. We like things BIG.  Sorry.
Little slip into sarcasm.

I do not agree with the perception that periareolar incisions are rare, altho
I wish they were banned because of their potential for destruction.  In my
city I can't tell you how often I work with moms who have had periareolar
incisions.  I've see three in the past 6 weeks. The attraction (?) is the
cosmetic effect achieved by hiding the scar at the areolar edge.  One is a
mom I'm seeing for the 2nd time.  She had not only the periareolar insert but
the surgeon kindly clipped her nipples when he did it because nursing her
first baby had 'stretched them all out and made them ugly."  Can you imagine
what sectioning them (slicing them off like a piece of salami!) has done to
her lactation capacity? Additionally, the outer packet in the left breast has
popped, tho the inner is intack, and the surgeon is advising more surgery to
replace it.  She got engorged on day 3, but has not produced more than about
.5 oz per feed (based on test weights) or pump.  This amount has been
consitent over the past 2 weeks no matter what we've done.

 I, like Nancy, also see women who had primary glandular insufficiency which
was the reason cosmetic surgery was sought.  These girls often had thyroid
dysfunction during adolescence and it wasn't just that they were flat.  I do
pursue in my history taking, some info about health and dev. in teen yrs.
when talking to mom with implants.  I take a wait and see attitude, because
nature can always surprise you, but these nursing couples need adequate pp
supervision.

Kathy D. mentions the stats may not be real reliable due to sample size, but
I sure appreciate the effort to begin to gather clinical data on the results
of this surgery.  I again see the great potential for this Lactnet link to
provide larger samples.  Nancy, you ought to share your questionaire (or
whatever data collection method you used --chart review-- I haven't seen the
article yet) and perhaps others who have seen these moms can share info.
 Maybe this is a dumb suggestion -- I don't have a research background.

Barbara Wilson-Clay, BSE, IBCLC
Austin, tx   priv. pract.  Its sunny and 70 here.