Breastfeeding/Lactation Consultant

I think there are many options that you can try depending on which works best and it may take a bit of trial and error to see just what feels most comfortable for you.

Let me try to answer your questions. First if the doctor thinks you can bf on that breast it's probably a very superficial incision and it's very encouraging to me the that doctor thinks it will be ok b/c they are typically more conservative than LCs about bf after surgery.

I wouldn't worry about the milk ducts. They are deeper in the breast and I imagine the removal of the mole is at the surface of the skin. I'm not sure what to expect re: the pain of the incision or with bf but here's where you probably have many options. I'd probably be inclined to try to bf from that breast if the doctor says it's ok and see how it feels. You can ask the doctor for pain medication that is compatible with bf and time the medication so it's at it's peak effect when you think a feeding will occur. There are may meds that are considered compatible with bf that are used for pain, for example after a C-section birth. I would think that the pain associated with your surgery would be well taken care of by meds that are used after C-birth. Don't be afraid to take the pain medication, especially since your baby is older it will have less of an impact on your baby than the newborns who are exposed to the pain meds after birth. If you have any questions about the specific medication get back to me and I can reference it for you and also ask your pediatrician about it since your ped knows of any special concerns that might apply to your baby.

If you find it too painful to bf on that breast you can opt to pump if you find that is more comfortable. If your pump is not comfortable you might consider getting a more comfortable rental pump for the time it takes for you to heal. I suspect you will heal quickly from this type of surgery so even if you opt to pump it shouldn't be for too long, maybe for just a few days or a week. You might want to ask the surgeon how long it takes to heal and how long it would be before the stitches would be removed. If you pump be sure you have a pump with automatic cycling. That means the pump automatically does the suck/release action, not that mom needs to press a button or cover a hole in the pump to make the pump suck and release. Set the pump at the lowest suction setting to start and only move it up to a higher suction as you feel comfortable with it. There is no advantage to pumping on high suction if it is hurting you. Make sure the pump you use also has a suction setting. If your pump has a setting to control how fast the pump sucks and releases probably the faster setting would be best b/c the faster it cycles the more 'releases' you will have and generally the more gentle the pump is. In general, put your pump settings at whatever feels most comfortable to you.

Another option might be to use a nipple shield (a thin silicone nipple you place over your nipple and areola during a bf session). I don't recommend them lightly b/c they can come with some complications in some situations. Also, if your baby has never used an artifical nipple, such as a bottle nipple or paci, I'd be reluctant to expose your baby to one at this point. However if your baby is used to taking bottle nipples and goes from breast to bottle easily it is probably less of a risk. There was one older study of the nipple shields that suggested that babies aren't able to get as much milk thru them in some circumstance. Another study showed that many babies do just fine getting milk thru the newer thinner shields. In your case the concern about not getting as much milk isn't a big worry as far as the baby is concerned b/c your baby will surely get adequate milk from the unaffected breast if need be, but it may be a concern if the breast isn't getting adequately drained b/c engorgement or overfilling may cause more pain and potentially complications for you. So if you opt for the shield you want to bf very frequently from that breast and make sure it's staying nice and soft. Actually no matter what option you choose, whether it's pumping or bf I'd strongly urge you to work toward keeping the milk flowing enough to keep the affected breast soft. Any back up of milk in your breasts is apt to make you more vulnerable to pain and complications.

You may also get some pain relief from cool compresses, but ask your surgeon about the safety of this on your surgical site. If you are allowed to use cool compresses the rule of thumb is apply them for about 20 to 30 minutes then take a break of at least 60 minutes before reapplying. You can use bags of frozen ice or frozen veggies wrapped in a towel, don't allow the ice against your bare skin. The way cool compresses work is they reduce the swelling that often is the main cause of the pain.

Get back to me after you speak to the surgeon and let me know if you have any questions.

Hope all goes well and you heal quickly.

Warmly
Kathy