Guest Post: Breastfeeding is Compatible with Surgery

Today's guest post is written by Christine Yusingco-Zubiri, a fellow N@Wie.  She shared her experience about continuing to breastfeeding despite undergoing breast surgery and I asked her to share it as a guest post in this blog.  I do admire her determination and hope that her experience will inspire pregnant moms or moms who are having difficulties during the early days of breastfeeding to continue to breastfeed. 

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Christine is a mother of two, who has had had her share of breastfeeding issues, from low milk supply, cracked nipples, mastitis, to latching problems. She is a working mother and her pump has been her bestfriend for quite some time. It was so hard to find information on mothers who had to have breast surgery while breastfeeding that she decided to share her experience.

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I had this lump on my left breast since I was around 20 years old. At that time it was still small and pretty much moveable and palpable. My mom brought me to a surgeon who said that it’s common for young women  to have lumpy breasts. A few years later I  consulted with an OB GYN who, after doing a clinical breast exam, concluded that it is most probably a fibroadenoma. I didnt bother to have it checked again but continued to do a self breast exam every month or so.  

It wasn’t until a colleague's wife was diagnosed with breast cancer that I took the lump seriously. I vowed to myself that I will have it checked again, but fear got the better of me. I am so afraid of hospitals and undergoing surgery. With all the breast cancer awareness campaign going around, I can't help but think about the lump again and again. I took another shot at having the lump checked. I was already close to my 30s by this time, married and living in Singapore

Breast lumps are taken seriously in the clinics here in Singapore. I was able to get the earliest available appointment with a breast specialist at a government hospital’s breast center. The doctor, after feeling my lump, asked me “What’s your pain tolerance?”. Before I could even answer “very low”, she already had a needle out and did a Fine Needle Aspiration biopsy. I froze.

My next appointment wasn’t until a few months after. I assume the biopsy results were ok otherwise the breast center would already be calling me. FNA showed the lump to be fibroadenoma. I was pregnant before we could plan for an excision biopsy.

Every 6 months since 2008 I went for ultrasound to monitor the lump. It was growing, but probably because of the pregnancy and lactation hormones. Every visit I would let the doctor know that I am still breastfeeding. I was fortunate that my doctor understands how important it if for me to be able to breastfeed my children. My breasts are meant to breastfeed... if it's something that can wait I would rather wait and breastfeed if only to use my breasts for their foremost intended purpose and give my children the best possible nutrition they can have in their early years. Fortunately the lumps were sonographically benign.... but we couldn't really be so sure until it was sent for biopsy.

Fast forward January 2012, I have been breastfeeding my second child for a year, the doctor said it's time to have the lumps taken out since they are growing and we should let it grow even more. I wanted to try to continue breastfeeding even with the surgery, I researched and corresponded with lactation consultants. I was in touch with one who wrote about her experience in La Leche League's magazine. She was able to nurse right after surgery. She was my inspiration, and so were many other women who shared their stories. 

I had the surgery scheduled just before the Chinese New Year break.It wasn't easy for me. I was pretty much still lactating. My breast doctor told me I could still continue to breastfeed but the surgeons said otherwise. I was determined to continue to breastfeed.

On the day of the surgery, I expressed as much to empty the breasts. Went to the Day Surgery Centre, checked in, changed into the hospital gown, and lay down on the bed assigned to me, waiting for my turn on the table. When the time came, I was wheeled in to the operating theater, asked several times about allergies etc etc by 3 different nurses.

Then came one of the surgeons, checked the lump by ultrasound, and made markings on my breast. She was surprised I was still lactating and intend to continue breastfeeding. And I heard the lines I most often hear or read about: ' You can't continue to breastfeed, the milk will leak out of your incision and the wound will take time to close' and 'Milk which is nutritious for the baby is also a good medium for bacteria'. The surgeons even asked me if I still wanted to go ahead with the operation. I was determined to face it head on, had the lumps taken out and get over with it.

It was a day surgery, I came is at 8 the procedure started at 10, by 12 I was already awake and by 3 pm I could go home already. There was pain on the affected area,

but nothing the painkillers couldnt handle. By the time I got home, my breasts were so full. I was told by the surgeons to stop expressing milk so as not to risk a milk fistula.

I was more afraid of mastitis and engorgement if I don't express. I pumped, taking care that the side with the incision is not moved.

I pumped just a little bit on the affected side to ease discomfort. For 4 days I was so engorged, ice packs were my best friends.

One week after the  surgery, milk started leaking on the incision area. I became a regular at the clinic for change of dressing :) and I got an 'I told you so" look from the surgeon.

They wanted to put a stitch on the side that opened up but I asked to let it drain first. Past experience has taught me to let things drain, what comes out must come out. I've read a lot about milk fistulas and they resolve in time. True enough, after 2 weeks of not stimulating the affected side, the fistula resolved by itself.

And the very good news of all... the biopsy showed the lumps to be fibroadenomas and galactocelles! Praise God.

I have a lot of realizations from this experience... the most important being... to be an advocate for one's self. No one can do this for me but me alone.