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Breastfeeding After Breast Surgery

If you have had any kind of breast surgery, it may impact your ability to produce as much milk as your baby needs. There are several things you can do to encourage your breasts to produce milk and make sure that your baby is getting enough nourishment.

Please inform your baby’s doctor and your lactation consultant if you have ever had breast surgery of any kind.

  • Breast surgery can impact both the amount of breast tissue and the nerve supply to the breast. Both of these are necessary for producing and releasing milk. It appears that breast tissue can re-grow, and the degree of growth of ducts and damaged nerves appears to be related to the length of time after the surgery. So the longer a women waits after surgery to breastfeed, the more milk she may be able to produce.
  • Nearly all breast reducing surgical techniques are likely to reduce the ability to make milk. The least harmful technique appears to be the “inferior pedicle,” in which the areola and nipple remain attached to a mound of tissue, called a pedicle, that contains the still-connected milk ducts and nerves.
  • Augmentation surgery (breast implants) appears unlikely to cause harm to milk supply, although it may result in problems with engorgement. The size of the breasts before augmentation is also important, as the need for augmentation may actually indicate insufficient glandular tissue. Thus low milk supply may not be a reflection so much of the surgery, but rather be related to the reason a woman chooses to have a breast augmentation in the first place.
  • The most common augmentation procedure is the “inframammary,” in which an implant is inserted in the fold where the breast meets the chest wall, under the muscle. It also does not tend to impact the ability to make milk, as neither the glandular tissue nor nerves are affected.
  • Silicone implants are considered inert and unlikely to be absorbed by the baby’s digestive tract, thus they are not contraindicated for breastfeeding.
  • A biopsy or lumpectomy of the breast may result in scar tissue that may increase the risk of plugged ducts in that area, or less commonly, may cut a nerve important to breastfeeding.

How can you increase your ability to produce milk following breast reduction?

  • Rent a Medela Symphony double electric breast pump. The pump can help you to build your supply, manage engorgement and avoid plugged ducts.
  • After your baby is born, hand express colostrum very often (at least every 2 to 3 hours) and once your mature milk is in, double pump at least 8 times a day for 5 to 10 minutes (after nursing) until you are sure you are making plenty of milk and baby is gaining well. If baby is not latching well and feeding at the breast, pump for ten minutes each time your baby is fed.
  • If weight gain is a concern, you may rent a good-quality, digital electric baby scale to follow your baby’s weight. Weigh your baby naked once a day to watch for weight gain. Babies may lose up to 7% of their birth weight in the first 4 days but should start regaining by day 4 or 5. Most babies are back to birth weight by day 10 to 14. Continue to weigh baby in the first few weeks to assure good gain.
  • You may also weigh your baby before and after your baby goes to breast. This will give you an idea of how much baby is removing and help you decide if your baby needs to be supplemented.
  • If your supply is low and you must supplement with formula, you can do this at the breast with a feeding tube, such as a Supplemental Nursing System (SNS) or a Lact-Aid. This will help to keep your baby interested in feeding at your breast.
  • You may want to discuss the use of a galactagogue with your lactation consultant or physician. A galactagogue may help to increase your supply. (See our information on Not Enough Milk.)
  • Remember, even if your milk supply is not sufficient on its own, you can still have a fulfilling breastfeeding experience. There is much more to breastfeeding than your milk. Breastfeeding is a relationship that enhances both baby and mother. Every drop of milk that your baby receives is precious and every moment a baby spends at your breast is worthwhile.
  • For additional information, see www.bfar.org. This web site is administered by Diana West, a lactation consultant and the author of Defining Your Own Success: Breastfeeding After Breast Reduction Surgery.

August 2017