Can I Breastfeed After Breast Reduction?
If you’re considering breast reduction surgery, you may be curious about whether or not you can breastfeed after the procedure. Breastfeeding is a wonderful way to bond with your baby and provide them with the nutrients they need to grow. But there are some risks associated with breastfeeding after reduction surgery, and it’s important to know what those risks are before making a decision about your future child-rearing choices.
What Is Breast Reduction Surgery?
Breast reduction is a surgical procedure that reduces the size of the breasts by removing excess fat, skin, and glandular tissue from the breasts. It can be performed on women who feel that their breasts are too large for their frame or who have physical discomfort due to their large breasts. Women who have had children and have stretched out their skin can also benefit from this procedure because it will help them regain their pre-pregnancy shape more easily. The procedure can also improve self-image in women who feel uncomfortable with their appearance because of heavy breasts.
can i breastfeed after breast reduction
Internationally, about a half-million women have breast reduction surgery each year. That’s the first fact. But what facts do you need to know about breastfeeding after breast reduction surgery?
1. It’s possible to breastfeed after having had breast reduction surgery
A decade or two ago, many women were unable to breastfeed after their breast reductions. But today, with surgeons using techniques that preserve the function of lactation-related structures, it’s highly likely you’ll be able to breastfeed.
2. Your breasts WILL return to their pre-pregnancy size
Whoa. Hear me out. All women can expect larger breasts during pregnancy. Due to the influence of estrogen and other pregnancy hormones, breast tissue enlarges. Simply stated, that means that pregnancy — not breastfeeding — will make your breasts larger.
However, many or most women — whether they’ve had reduction surgery or not — will find that their breasts will return to their pre-pregnant size after they wean.
3. The breast ducts can undergo recannualization
Often, the ducts — the “transport system” for milk — are severed during breast reduction surgery. However, there is good evidence that some of these ducts reconnect to one another, or some new transport pathways develop. Think of this as being similar to “collateral circulation” that cardiac patients develop. Sure, it’s a little different, but the main idea is that the body develops a natural bypass around the injured tissue.
How much recannulization will occur? That depends on a number of factors, but it seems that the act of lactating triggers the body to create these alternative “routes” for transporting the milk. Hence, a mother breastfeeding post-breast reduction might have a low supply when nursing her first baby, but she has a better supply with her next baby.
4. The nerves can become regenerated
The 4th intercostal nerve signals the brain to release oxytocin and prolactin. If this nerve is severed, milk ejection (“let-down”) will not occur. Unlike the situation with ductal recannulization, lactation does not influence nerve.
While most nerve damage recovers within six months to a year, it can take up to two years for nerves to regenerate. (You can read more about nerve repair and regeneration.) And, sometimes, the nerves never regenerate.
5. You can increase your milk supply
In all mothers, milk-making depends on a positive feedback loop. By this, I mean that the more you remove milk, the more your breasts will refill with milk. Basically, with positive feedback loops, the idea is, “the more, the merrier.”
There is a caveat to this. The average woman has about nine ducts. However, some women have as few as four ducts. Obviously, women who have fewer ducts to begin with are more affected by having even one duct severed during the surgery.
Remember, too, that just like any other woman, it’s possible you aren’t making enough milk for some other yet-unidentified reason.
6. It’s likely that you’ll experience your milk “coming in”
Although all mothers have colostrum at the time of birth, at about 3 or so days, their milk “comes in.” So, you may find that your breasts feel full around that time. Having your milk “come in” is a good thing! Engorgement is normal, and desirable.
7. Your past surgery is not “causing” engorgement
Hormones cause the milk to come in. If your hormones are working properly and your lobes are intact, your milk will “come in” whether you breastfeed or formula-feed; whether you have had breast surgery, or not.
But if you’re breastfeeding after breast reduction surgery, you may notice that:
- part of one breast is more engorged, and part remains soft
- you have more engorgement on one side than on the other side
- your discomfort with engorgement is likely to increase each time you have a baby
Some moms worry that the discomfort indicates a plugged duct. That’s certainly possible. But more often than not, natural engorgement causes the discomfort. Discomfort will subside.
8. The type of incision used for your surgery might affect your breastfeeding experience
Might.
A recent systematic review by Kraut and colleagues was encouraging. They concluded that “Techniques that preserve the column of subareolar parenchyma appear to have a greater likelihood of successful breastfeeding.” (The subareola parenchyma is the lactating part of the gland just under the areola) So in the initial consultation, it’s important to emphasize to the surgeon that you want to maximize your chances for breastfeeding.
If you’ve already had the surgery where the surgeon used techniques associated with a lesser likelihood of success, take heart. Breastfeeding after breast reduction surgery is often still possible.
9. One breast may produce more than the other
Even among women who have not had breast surgery, sometimes one breast produces more milk than the other. Such a difference, if not too dramatic, can be entirely normal — or at least common.
The real question is, do you have enough milk from both sides to support the baby’s growth and well-being?
10. Multiple techniques help to improve milk supply
It’s entirely possible that you won’t have a full milk supply. You may need to supplement. But there are techniques to help you improve your milk supply.
These days, most mothers turn to the internet and social media for “advice” about milk production. Does this advice work? We can talk about that later, but bottom line is this: NOTHING substitutes for frequent stimulation, and skin-to-skin contact.
breastfeeding after reduction tips
What steps can I take to increase my milk supply after delivery?
• Feed your baby at the breast early and often.
Attempt to feed your baby at the breast as soon as possible after birth,
preferably in the first hour of life. Continue to breastfeed your baby as
often as possible when they are awake and demonstrating hunger cues:
thrusting tongue, licking lips, bringing hands to the mouth, rooting.
• Remove as much milk as possible.
The first 2 weeks postpartum are a “critical” time in lactation. The more
milk you remove during this time, the more milk-making capacity your
breasts will have. Frequent feedings at the breast will provide excellent
stimulation to increase your milk-making capacity
• Consider using a breast pump
If your baby is not able to latch effectively at least every 2-3 hours and
maintain a vigorous feeding for at least 15-20 minutes, then it is vital that
you use a double electric breast pump to provide the additional stimulation
your body needs to make milk.
• Avoid pacifiers
Your baby is designed to eat frequently. If your baby is showing any signs
of hunger, it is important to respond to those cues by offering the breast
instead of a pacifier. This is especially important during the first 2 weeks
when your milk supply is being established.
How will I know that my baby is getting enough at the breast?
Most newborns have a very effective feeding at the breast immediately after
delivery and then sleep for several hours. As they begin waking up again, it is