Around the world, many women of childbearing age may need, may choose, or have had breast surgery or trauma of some type. In the US, (based on 2004 statistics) ½ million women of childbearing age have breast surgery each year. This is estimated to translate into the possibility that 10-20% of the women who are hospitalized in a mother-baby unit after giving birth may have been affected. The surgeries are of many types (augmentation, reduction, lift, correction of inverted nipples, biopsies, removal of cysts, abscess drainage, piercings, etc.) and the potential results and effects on breastfeeding are also varied. Health care providers need to know how to recognize signs that surgery (or other trauma) may have occurred and further assess the potential impact through history and physical exam. Many women receive conflicting information about expectations related to breastfeeding and how it may be affected by their surgery history. Because the impact of surgery or trauma may significantly alter the course of breastfeeding, the care provider must be able to make appropriate recommendations, based on currently available evidence, for intervention, evaluation and follow-up care. Health care professionals skilled in the care of childbearing women and their babies may also be called upon to provide anticipatory guidance to women who are considering making surgical decisions, or who have had breast surgery and want realistic information about the possible impact on lactation. This presentation will provide practical guidance for multidisciplinary care in these circumstances.