While I have been lurking for a couple years, I have not posted for a while, and I need to ask your collective advice. A client came to see me today and has given permission for me to post to the list. Her baby is three days old. She was latching at the breast the first day, but the baby had only 1 stool in the hospital, so she was instructed to give formula. Since then, the baby latches, but releases quickly and tires easily. Probably also gets frustrated since the milk is not readily available as in the bottle. The baby also looked slightly jaundiced today. At this point, the baby is offered the breast, but is mostly formula fed. Has had only one more meconium stool (Meconium stained amniotic fluid plus one small mec in hosp). Has sufficient wet diapers. Her history is that she has polyurethane coated silicone implants (Replicon implants - the ones that were taken off the market). Because of difficulties, she had reconstruction but elected to have the same type of implant. This was 13 years ago. Her nipples have been removed and reattached. The main concern is whether or not she be able to make sufficient milk and will this type of implant cause problems with her baby. She quoted a study that said this coating breaks down into TDA, a compound that can cause liver cancer in rats. She knows that the silicone is not a concern. She is frustrated because she is going to all this trouble and if the baby will be "harmed from the milk due to the implants" then she wonders if it is worth the effort. She is also very exhausted. Today the baby did latch, and did suck well, but did not maintain sucking for any period of time. I did discuss using an sns at the breast, but she elected to wait on that option. The use of a syringe at the breast did encourage the baby to maintain the latch and nurse. I taught them finger feeding with the syringe. We also used the classic pump and obtained about 1cc of colostrum form one breast but only a few drops from the other. While her breasts are warm, they did not feel any larger to her. We discussed the importance of regular stimulation, whether it is the baby effectively nursing or using the pump. We also discussed the possibility that we will not know how much milk will be available until her milk is in and she is either pumping or the baby is nursing effectively. I have searched the archives with no matches. Also, neither Lawrence or Riordan address nursing with this type of implant in detail as it has been off the market for many years. I am hoping that someone can provide me with info in regard to the safety of breastfeeding with Replicon implants. I look forward to your collective wisdom. Sincerely, Linda Goldberg, RN, CCE, LC in training Central Florida, USA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html