Many women have had breast surgery of some kind. This includes breast augmentation to enlarge the breasts or breast reduction to reduce them. But can you breastfeed if you have had breast surgery?
Yes, usually, you can breastfeed after breast surgery, but how successful you will be depends greatly on the type of surgery you had and how it was performed. Even if you are only able to produce some milk, breastfeeding would be good for your baby even if you must supplement it with formula.
Milk is produced in the glandular tissue of your breast and travels to your nipples though what are called the milk ducts. If you have has surgery on your breasts, what matters is whether your milk ducts were severed or interrupted in any way by the surgery. In some surgeries, some milk ducts are cut while others may not be. Even if milk ducts have been cut, they may heal after surgery and be able to bring milk to the nipple.
If you have had any type of breast surgery and want to breastfeed, talk to your obstetrician or midwife about it during your pregnancy. If possible, provide them with the medical records of your surgery. Make sure your baby’s pediatrician knows you have had breast surgery and are breastfeeding so that he or she can pay closer attention to your baby’s growth.
Most surgery to increase the size of your breasts involves inserting silicone or saline implants. These implants are placed either beneath your natural breast tissue or beneath your chest muscles. Most women who have breast implants usually produce a good supply of milk.
The implants themselves usually do not interfere with breastfeeding because they are under your natural breast tissue, but the way they were inserted might cause a problem. In order to avoid visible scarring under the breast or in the armpit, some surgeons insert the implants through an incision at the edge of aureola, the bumpy tissue around the nipple. This could sever the milk ducts and interfere with your milk supply.
Breast reduction involves surgically removing breast tissue and reconstructing the breasts into a smaller size. Depending on the size of your breasts and how much you want to reduce them, this surgery can be extensive. Most surgical techniques move the nipples and areolae, which can damage the milk ducts, while others remove the nipple and then reattach it, which sever the milk ducts completely. In addition, the surgery can sever nerves that are important in breastfeeding.
Nearly all breast reduction techniques will reduce the amount of milk you can produce. Techniques that remove and reattach the nipple are most likely to cause problems or completely prevent successful breastfeeding.
After you give birth, breast tissue that leads to blocked milk ducts will produce milk that has no way to get out, which can lead to engorgement. The swollen areas of your breasts can be painful for several days after your milk comes in. The blocked areas will stop producing milk in a week or so, but any areas with intact milk ducts will continue to produce milk if you breastfeed.
Many women who have had their breasts reduced will produce milk and can breastfeed their babies. However, the amount they produce may not be sufficient and they may need to supplement their supply with formula.
Talk to a Lactation Consultant
If you are a woman who has had any kind of breast surgery and you are thinking about breastfeeding, talk to a lactation consultant. Lactation consultants are health professionals who are trained to teach a mother how to breastfeed her baby and help deal with any problems concerning breastfeeding. Because surgery to the breast may reduce the amount of milk you can produce, you should learn to judge how much milk your baby is getting. A lactation consultant can help you determine if your baby is getting enough milk.
Your obstetrician or midwife will usually be able to recommend a local lactation consultant. You can also check the International Lactation Consultant Association for local consultants.
A good resource for any woman who is thinking about breastfeeding after breast surgery is BFAR.org, which promotes breastfeeding after breast surgery.
Thibaudeau S, Sinno H, Williams B: The effects of breast reduction on successful breastfeeding: a systematic review. J Plast Reconstr Aesthet Surg. 2010 Oct; 63(10):1688-93.