Abstract
Dear Editor:
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A 39-year-old woman, para 2 gravida 3, in her 33rd week of gestation came for breastfeeding counseling. Upon observation, she had a severe scalding scar that had developed at the age of 8 years, involving the right breast and upper limb and partially on the abdomen and neck. The right nipple areola complex was completely missing, as well as part of the glandular portion of the breast. Reconstructive surgery had been performed at the age of 19 years, in order to achieve a good cosmetic outcome, by using a prosthesis and a skin flap from the groin as a donor site. Symmetric appearance was obtained.
She had had two previous normal pregnancies with vaginal deliveries but did not even initiate breastfeeding. In the current pregnancy, following her midwife's suggestion, proper prenatal lactation counseling was provided. Presenting several examples of other patients who nursed successfully was helpful to confirm the feasibility of breastfeeding. 2
The patient gave birth vaginally to a girl weighing 3,115 g with Apgar scores of 9-10-10. She put her baby to her breast within 2–3 hours following delivery. Frequent feedings and additional pumping were recommended in order to stimulate an adequate milk supply and to obtain expressed breastmilk for supplementation (Fig. 1). By the end of the first week postpartum, the infant had regained her birth weight and kept gaining gradually. Neither galactogogues nor formula was required. After 30 days, the mother stopped using the pump while still breastfeeding. The infant breastfed until she was 14 months old.
Unilateral breastfeeding in this case.
Our case report is really uncommon but emulates what a breast cancer patient undergoing a mastectomy experiences. 3 Healthcare providers often discourage a willing mother from breastfeeding. Both patients and physicians should be informed that milk produced by one breast can be sufficient to meet the nutritional needs of a newborn. 3 Proper lactation counseling is a key factor for the success of breastfeeding, which in turn may have a positive effect on the long-term outcome. 4