In most cases, breastfeeding after a breast reduction is possible, but women should be prepared for potential difficulties. Being armed with information and a strong support network are the most important ways a woman can be prepared for breastfeeding after a breast reduction. It is also important to realize that many women, regardless of surgery, experience difficulties with breast feeding early on, so persistence and patience are also key.
In early breast reduction surgeries, doctors often removed the entire nipple, severing the milk ducts. Modern breast reduction surgeries, however, are usually done in such a way that the nipple is merely repositioned, leaving several milk duct connections in place. Women who have had the latter type of surgery can breastfeed successfully in most cases. While milk ducts may have been damaged in surgery, they are able to repair and reconnect themselves, usually within five years or less and more quickly during pregnancy. Ducts also function better with use, so breastfeeding subsequent children will be more successful if the first is breastfed.
One of the biggest concerns women have about breastfeeding after a breast reduction is that their milk supply will not be great enough to nourish the baby. The most effective way to increase milk supply, however, is to increase demand through frequent nursings and by employing a breast pump for a few minutes after feedings. This sends signals to the milk ducts to produce more milk, a process that will become regulated after the first few weeks of the baby’s life.
Herbal supplements, like fenugreek and milk thistle, are thought to increase milk supply, as well as eating oatmeal and drinking plenty of water. It may be difficult, however, to measure how much milk is actually being produced. If the baby is swallowing during feedings, producing six to eight wet diapers and three to five bowel movements per day, and gaining weight regularly, then breastfeeding is successful.
Increased tenderness, soreness, and sensitivity in the nipple may occur during breastfeeding after a breast reduction. This is caused by the scar tissue and disrupted nerves surrounding the nipple. There may, however, be no sensation in the breast, including the “let-down” sensation that nursing mothers usually feel when milk begins to flow from the ducts to the nipple, but this will not prevent milk from flowing.
A lactation consultant is an excellent resource for making sure the baby is positioned correctly during feeding and for general support with breastfeeding problems. Breastfeeding can be challenging for any new mother, regardless of a previous reduction surgery, so a having a supportive network and reading success stories are key. Any amount of breast milk is very good for a baby, so even if exclusive breastfeeding does not work, supplemented breastfeeding can be better than not breastfeeding at all.
