|
BREASTFEEDING
AFTER BREAST REDUCTION
Jennifer:
Is there any early way to tell if a woman will definitely be able
to breastfeed? I had a breast reduction three years ago, and although
I seem to have slight sensation around my breasts, the nipple/areola
area has always been more sensitive then before my operation.
Curious if that is a good sign? I'm hoping to breastfeed! Thank
you for any advice or guidance in advance :) Jennifer
Anne:
I have worked with many women who have had breast reduction surgery
over the years, and have seen outcomes ranging from no milk production
at all to full production. The only way you will know for sure
how your body will respond is to try breastfeeding and see what
happens.
The outcome
depends on many variables. Some milk ducts are almost always cut
during a breast reduction, but if a surgeon makes a deliberate
effort to leave the blood supply and nerve pathways intact, it
is certainly better than if he removes tissue without regard for
these concerns. I would like to think that most doctors who are
doing reduction surgery on young women of childbearing age would
try to preserve these structures, but that is not always the case.
Another variable
is how much tissue was taken out during the procedure. The more
glandular tissue that is removed, the less the chances are of
producing a full milk supply.
Another factor
to consider is whether the nipples were completely removed and
repositioned (the free-nipple technique, most often used for women
with extremely large breasts) or whether the pedicle technique
was used (the nipple stays attached to the breast gland on a strip
of tissue, which means the ducts, blood supply, and some nerves
remain intact, making successful breastfeeding more likely). The
free-nipple technique involves completely severing the blood supply
to the nipple and areola, and some degree of nerve damage invariably
occurs. Complete breastfeeding without supplements is rarely possible
if the free-nipple technique is used.
If milk ducts
were cut during the surgery, you may produce a full supply of
milk, but not be able to pass it all through the damaged ducts.
The more ducts that have been damaged or severed, the less milk
the baby will receive. There have been some reports of mother's
milk ducts growing back (this is called "recanalizing") although
this is unusual.
Usually, if
major nerves were cut during surgery, you would have little or
no sensation in your nipple and areola, which can decrease milk
production because the baby's sucking stimulates nerve endings
which send the pituitary gland the signals to produce and let-down
the milk. The fact that you still have sensation in your nipples
is very encouraging, but you still won't know how breastfeeding
will go until you try.
You may experience
more engorgement than a mother who hasn't had surgery, because
the milk may back up in the damaged ducts and lead to swelling.
Within a few days, the milk will be reabsorbed in those areas
and you will be comfortable again.
You will need
to monitor the baby's urine and stool output and weight gain carefully
to see if a supplement is needed. It certainly makes sense to
breastfeed your baby, because almost all mothers will produce
some milk after reduction surgery, and you can still have a nurturing
breastfeeding experience even if your baby gets some breastmilk
and some formula. Some mothers who haven't had breast surgery
don't produce a full milk supply and have to supplement, and some
choose the option of combining both from day one. Any breastmilk
at all is good for your baby, and you can still experience all
the bonding and closeness of nursing your baby regardless of the
amount of milk that you produce.
The best advice
I have for you is to try to contact your surgeon to get more details
about the type of surgery that was performed so that you know
what you are dealing with. Educate yourself about breastfeeding
in general, just as you would if you hadn't had the surgery. Be
aware that you may not produce a full supply, but plan to enjoy
nursing your baby while making sure that he/she gets enough milk
one way or the other.
The main Breastfeeding
after a Reduction (BFAR) website:
http://www.bfar.org
Back
to Anne's main page |
Next Question
|
