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Weaning on one side?

2042 Views 6 Replies 2 Participants Last post by  NameThatMama
I may need to wean on one side in order to deal with a milk fistula. (I emailed Jack Newman, and that was his advice.)

Where do I go to find out about how to do that? What do I need to do in order to relactate normally after the fistula heals?
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How did the fistula happen? Where is it? The only time I've ever heard them referred to regarding bfing is with abscesses or after breast surgery. I looked high and low online for information when I had an abscess, and found very little out there. What will it take for the fistula to totally heal? Do you need to be totally "dry" for it to heal? Its not unusual for some women to have some milk for a long time after their child is weaned.

Nursing on just one side is possible, but then if you have any problems on the remaining side, you are up a bit of a creek. Bringing back the supply on the second side may be a simple as pumping and/or putting baby back to the breast on that side. How old is your child?
I had an excisional biopsy three weeks ago. The lump, a ruptured duct, was removed, and now I have a great quantity of milk spilling out of the incision site. Initially, it was only coming out the very bottom (3mm of the 3cm incision), but now the wound is eroding, and I'm leaking out of three spots along the incision. It's on the left breast in the 9 o'clock position, about 2 inches from my midline.

I don't know if it needs to be *dry*, but it needs to be drier than this. I hope to relactate on that side after it heals, and I have tentative plans for how to go about doing that (pumping, galactagogues, nursing--repeat).

My daughter is 6 months old. She's 99.9% breastmilk-fed; since Monday, we've been giving her tastes of solid food, but it's not any significant portion of her caloric intake.
Thanks for sharing your experience. I'm sorry to hear that you are dealing with this. What I'm hearing is that you need to at least slow down the production enough there so that the incision can start healing, and now that's not happening.

Do you need to wean cold turkey on that side? If so, be sure to express off enough periodically so that you don't become engorged or get plugged ducts or worse. Is is possible for you to do this somewhat gradually? There are a few ways you could do that - offer this breast after the first at each session, offer it for shorter periods of time, or for fewer sessions each day.

As far as relactating on that side, I would start with offering the breast and/or pumping, before you try introducing galactagogues. Presumably you will have a full supply on the right side while the left side heals. If so, you don't have a supply problem - which is what galactagogues are for - you just want to re-balance your supply between your 2 breasts. It may not be necessary to get up to a 50/50 split with the right and left sides, or it may happen gradually with a bit of time after you go back to 2 sides. I would just aim for at least *some* supply on the left side, so that you don't get up a creek if you have any challenges on the right side later on.

When women wean (on both sides), it takes many mums a lot of months before their breasts are totally dry. Its a hunch, but if you stop on that side for a few weeks (how long do you think it might take to help the incision start healing?), but are still nursing on the other side, its my guess that you'll still have some production on the left side, but hopefully it will slow down enough to let the incision heal. Just a hunch - production is independent between the 2 breasts, and stimulation and emptying the breast are the most important factors for supply. Are there other mamas who have nursed only on side who can share their experiences?

It is possible that your baby will develop a preference for the other side. Be patient with your baby, and if its a difficulty, try using some of the nursing strike techniques to get baby back to that breast - skin to skin contact, offering the breast when baby is sleepy or asleep, while in the bath, etc.

I hope this helps. You are one tough mama!
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Thanks for the support and encouragement. I'm not going to try to wean cold turkey, because I need to give the non-fistula side a chance to increase production, but I am going to try to switch to one side pretty quickly (over several days). Right now, I'm just focusing on favoring the non-fistula side while nursing and only pumping enough off the fistula side to stay comfortable.
Sounds to me like you have a pretty clear idea where to go with this.

I've been through quite a few nursing transitions - nursing on one side, exclusively pumping, going back to the breast, nursing after surgery. Its easy to get totally wound up with making "the plan". Just take it a day at a time, and the next steps will probably present themselves to you. Maybe that is just me - I get stressed out making a lot of plans - but it worked for me.

Just be sure that you have a thorough understanding of how your supply works (which I'm reading between the lines that you do). Here is a good link. If you're not sure how to proceed, maybe have a read, and see if the next step appears to you.

Good luck. This sounds workable to me! Let me know how things work out!
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Ehn. I'm having a tough time increasing my supply on the non-fistula side enough to keep up with pumping. I have about two gallons of milk stored that I can use while I'm at work, but I had hoped my supply would increase a little faster than this.
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