Breastfeeding: Breastfeeding after reduction surgery

When I was 18 I had a breast reduction. My surgeon and my GP tell me that there is a high risk that I will not be able to breastfeed, however no way of knowing until I have a baby and try! I have not been able to find any information about women breastfeeding after a breast reduction. Can you help?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

There are two basic types of breast reduction surgery, or reduction mammoplasty. In one, the nipple and areola remain attached, while excessbreast tissue is removed (pedicle technique.) In the other, which is most commonly used for very large breasts, both nipple and areola are completely removed, severing glands and nerve pathways (free-nipple technique.) If ducts and nerves remain intact, breastfeeding is possible. It is unlikely that breastfeeding will be successful if the areola and nipple have been completely removed and repositioned, as in the free-nipple technique.

In a 1992 study, "Is breastfeeding possible after reduction mammoplasty?" by Harris, Morris and Freiberg in Plastic Reconstructive Surgery, 68 patients were followed after reduction mammoplasty (pedicle technique). Twenty became pregnant and all produced milk. 13 (65 percent) decided not to breastfeed, and 7 (35 percent) breastfed successfully.

Even if milk ducts and nerves have been cut or damaged during surgery, it is impossible to know for sure if you are able to breastfeed until you try. If it is determined that your milk supply is insufficient, a nursing supplementer can be used while breastfeeding. This allows your baby to benefit from the closeness of nursing, while receiving the milk you are able to produce, along with necessary supplementation.

I would recommend working with a Lactation Consultant familiar with your particular situation. She will be able to help you in positioning your baby to best access your milk, to deal with problems of breast engorgement (that can be more common in women who have undergone breast surgery), and in evaluating your milk supply. To find a Lactation Consultant in your area, contact ILCA (International Lactation Consultant Association) atilca@erols.com.

It is important that your baby's output be monitored in the first six weeks following the birth. Your baby should be having six to eight wet diapers and at least two good sized bowel movements each day. Weekly weight checks are also important during the first six weeks to be sure your baby is receiving the proper nutrition.

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