Dear Fiona: You may get two postings from me on this as I'm not sure you received my first. The lady may well be able to continue nursing on the breast with the incision. It is too early to tell how many ducts were severed, and even if some were, she could still nurse. Also, since the trauma was from a seat belt, I assume the hematoma was on the inner aspect, therefore doubt significant damage to the crucial nerve supply for the areola. If the incision isn't right on the areola, it should not preclude nursing. Marianne Neifert gave a talk about the effect of surgery on lactation and referred to cases of continued nursing after breast biopsies, with good healing even if rare milk fistula developed. It is also common to allow mothers to nurse after I&D of breast abscess, depending on location. Another option for this patient is unilateral nursing, with subsequent involution of the affected breast. Two references from her talk, which I personally have not read, are Breastfeeding after breast surgical procedure or breast cancer. Neifert M. NAACOG's Clinical Issues in Perinatal and Women's Health Nursing 3(4):673-82, 1992; and Barker P. Milk fistula: An unusual complication of breast biopsy. J R Coll Surge Edinb 1988;33:106. Hope this helps. Alicia. [log in to unmask]