Q&A: surgical meopause and breastfeeding

Kelly writes:

"Here's a doozy! My sister will need to undergo surgery that will put her in surgical menopause (she's 36). She is desperate to know if anyone has been through a similar situation and has advice or tips for her about what to expect, what to do and what not to do.

Additionally, she will be in the hospital for 3-5 days, and is still nursing a three month old. Again, any tips?

Also - is there anything important she needs to be aware of or plan for when nursing a baby after menopause? Is it possible?

I'm hoping some of your readers will have some info."

No kidding that this one is a doozy. It's actually two questions in one, and I've got real suggestions for one and mere speculation for the other. Let's start with what I know.

The easy question is about how to manage the nursing while in the hospital. She's going to need to pump, pump, pump like the wind before she goes into the hospital to get up as much of a stash as possible. While she's in the hospital she's obviously not going to be able to keep up the same nursing schedule, even if someone can bring her the baby a few times a day (who even knows if the hospital will allow that). And she may be taking medications that aren't compatible for nursing, so it's possible that she won't be able to nurse at all while she's in the hospital.

The trick is to make sure there's plenty for her baby to eat while she's in the hospital (either pumped milk or formula or a combination), and to keep her milk flowing while she's in the hospital. She should arrange ahead of time to rent a hospital pump while she's there, and pump as often as she can. If she has to pump and dump because of medication it'll be a shame but not a tragedy, because the goal is just to keep her supply up so she can nurse again when she gets home and doesn't have meds in her system.

(I'm going to assume her baby switches back and forth between breast and bottle, since you probably would have mentioned that if it were a problem. It's possible that the baby will develop a preference for the bottle if she's in the hospital for awhile. To try to mitigate that the people feeding the baby should use the slowest-flow nipples they can find, and then your sister should spend tons of skin-to-skin time together in the weeks after she comes home from the hospital.)

There's great information about breastfeeding when a mother has surgery at (where else?) Kellymom.com at http://www.kellymom.com/health/illness/mom-surgery.html.

Now for the question I don't know the answer to (but you know I'm going to take a stab at it anyway), which is will she be able to nurse after surgical menopause. My guess is that she will be, because nursing itself produces hormones that give the body the feedback loop to keep producing more milk. Nursing  also supresses the hormones that regulate a menstrual cycle, so my non-scientist guess is that the hormones that won't be there after the surgery aren't involved in the production of milk.

Now, clearly I'm talking out of my hindquarters, so someone with actual knowledge of the relationships of all the kinds of hormones to each other needs to step in and tell us all the real answer. Who's got a real answer for us?