Can You Breastfeed After Breast Reduction Surgery?
By Gwen Morrison
When asked whether it is possible to breastfeed after breast reduction surgery, most people will automatically answer, “Probably not.” This is not a true assumption, says Diana West, author of Defining Your Own Success: Breastfeeding After Breast Reduction Surgery.
“Many women who have had breast reduction surgery do not even consider breastfeeding but rather bottle feed their babies from birth onward.”
“Many women who have had breast reduction surgery do not even consider breastfeeding but rather bottle feed their babies from birth onward,” she says. “Other women who have had breast reductions try to breastfeed but are ultimately unable to, perhaps because the surgical damage was too severe, but very often it is simply that these women lacked adequate information and support.”
Anything Is Possible
Anything Is Possible
With the current advances in surgical techniques for reduction mammoplasty, surgeons are increasingly able to preserve milk-producing tissue so that it is possible for some women to breastfeed after surgery. West, who is the executive director and founder of BFAR, a non-profit organization that provides information and support to women who wish to breastfeed after a reduction, points out that the techniques that have resulted in the most milk production are those in which the nipple was not completely severed, even thought it may have been moved.
“Fortunately, most BFAR (breastfeeding after reduction) mothers can produce some amount of milk,” says West. “Any amount they are unable to produce can be supplemented at the breast using an at-breast supplementer. A mother does not require a full milk supply to feed her baby at the breast.”
Karen Poulin from Manchester, Connecticut, remembers those early days after her baby was born. “When I was 23 years old, I had breast reduction surgery,” she says. “At the time, my surgeon said there was a 50/50 chance of breastfeeding. I thought it wouldn’t matter, who knew what the future held anyway. I never gave it another thought until I was due to have my first child.”
Poulin says that her first attempt at nursing is still a total blur. Her baby was having trouble latching onto her breast. “When properly latched, he wouldn’t suck well,” she says. “When poorly latched, he’d suck like a champ.”
Worried about how much nourishment she was providing her baby, Poulin nursed with a supplemental nursing system (SNS). “For about four weeks, I’d nurse with the SNS, pump from the side Samuel didn’t nurse from and then clean the SNS and pump parts,” she says. “It was a vicious cycle. The good news is that after the first four weeks I was able to ditch the SNS and nurse bare.”
According to West, many women believe that it’s impossible to breastfeed after reduction surgery in part because of misinformation provided to them by their surgeon or physician. In order to provide a place for women to go for help, West co-founded a resource center for women to learn more about breastfeeding after reduction surgery. She has worked with hundreds of breastfeeding mothers in her capacity as a La Leche League Leader.
“My professional and personal experiences have now convinced me that it is possible to breastfeed after breast reduction surgery if these three factors are present: at least one breast and nipple, information, and support,” she says.
West remembers her own experience as she sat in the plastic surgeon’s office discussing the ramifications of her reduction surgery. “The topic of breastfeeding came up, and he looked me in the eye and said, ‘You do know that you probably will not be able to breastfeed,’” she says. “Certain of my decision and probably wary of anything that could threaten it, I brushed off his warning with the casual reassurance.”
It wasn’t until she was pregnant with her first child that the surgeon’s words came back to haunt her. “Plastic surgeons’ statements about post-surgical lactation capabilities tend to stick very firmly in the minds of women when they consider breastfeeding,” says West. “Most BFAR mothers can tell you exactly what their surgeons said to them about it, and those words can haunt them in the early days of their breastfeeding experience.”
When consulting with a plastic surgeon prior to surgery, women are usually advised that the surgery will affect their lactation capability to some degree. The doctors commonly describe this capability by either stating that there is no possibility that the woman will be able to lactate, a 50 percent chance or that it will not affect her capability at all.
“When I was pregnant, I deliberately skipped descriptions of how to breastfeed, not wanting to set myself up for guilt and disappointment,” says West. “It may be that the reason surgeons tend to predict post-surgical lactation capabilities in terms of ‘all’ or ‘nothing’ is because the process of lactation is not well understood by so many physicians.”
Contrary to her physician’s advice, West immediately put her new son to her breast and felt a sense of deep satisfaction. “I was able to express several drops of colostrum from each breast when I was in my 8th month of pregnancy,” she says. “I remember feeling proud of my breasts, as if they weren’t going to let me down after all. Strangely, I hadn’t been aware that I felt that way until then.”
West used the SNS so she could nurse her son and supplement simultaneously. Though with her first son, she had to give in to the bottle, her second son was a different story. “When Ben was born, he was put to my breast with the cord still attached,” she says. “We went home a few hours later and began our breastfeeding relationship. He nursed almost continuously for the next few days. I never had to supplement at all.”
Success: Different for Every Woman
How do you define successful breastfeeding? The answer to that is unique to each mother who nurses. Most women who have had breast reduction surgery answer that question with, “We define our own success.”
Success in itself is not an absolute term referring to a continuum of less to more milk produced. For most nursing mothers, it can be described by the degree of satisfaction each woman and her baby derives from the relationship that is created through breastfeeding.
“Each woman’s experience of success will be different,” says West. “It is not determined by the amount of milk a woman produces. Some women will be able to breastfeed exclusively, while others may need to supplement the baby’s entire nutritional requirement. But even those women can supplement their babies at the breast, much like an adoptive breastfeeding mother does.”
Carol Maranta of Ontario, Canada, successfully breastfed her babies and offers this advice to new mothers: “Breastfeeding after reduction surgery added an extra dimension to learning to care for my new baby in the first few weeks after birth. I learned that breastfeeding is far more than nutrition alone, and that it is worth the extra effort I had to put forth to encourage and maintain our breastfeeding relationship.”