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Breastfeed After Breast Surgery?

©iStockphoto.com/Opla

©iStockphoto.com/Opla

by Amy Spangler
February 21, 2012

I had breast reduction surgery a few years ago and I am pregnant now with my first child. I would like to breastfeed my baby. Are there any special concerns?

Some women who have had breast reduction surgery are able to breastfeed fully while others are not. Your ability to breastfeed will depend on the type of surgery, the location of the surgical incision, the amount of breast tissue removed, and whether nerves, blood vessels, or milk ducts were damaged in the process. Even something as simple as a lumpectomy (the removal of a breast lump) can affect milk production.

Women who have had breast reduction surgery may find that their milk production is limited. With the removal of breast tissue, nipples and areolas are occasionally repositioned on newly formed breasts, which damages milk ducts, nerves, and blood vessels. You can still breastfeed your baby, but you may need to supplement with donor human milk or infant formula if your baby gains too little weight. Let your baby’s doctor know about your surgery, so that he can check your baby’s weight frequently during the early months to ensure that your baby is getting enough to eat.

Most women with breast implant surgery (breast augmentation) can breastfeed fully, without having to use supplements. However, breastfeeding problems are more common in women with breast implants compared to those without. When incisions are around or near the areola, the risk of damage to milk ducts, nerves, and blood vessels is greater. Women concerned about the condition of their implants (particularly women with silicone implants) are urged to get a magnetic resonance imaging (MRI) exam, which will show if the implants are intact or leaking.

Lumpectomies rarely cause breastfeeding problems unless the incision is on or near the nipple and areola. If a breastfeeding mother discovers a cancerous lump that requires radiation or chemotherapy treatment, she may need to interrupt or stop breastfeeding. Talk with your doctor and your baby’s doctor about a treatment plan to determine whether it’s necessary to interrupt or stop breastfeeding. The Infant Risk Center can also provide valuable information about which treatments conflict with breastfeeding.

Women who have had a mastectomy (the removal of a breast) can still breastfeed on the remaining breast, using a variety of breastfeeding positions.

If you are considering having breast reduction or breast augmentation surgery and know you want to breastfeed, talk with your surgeon beforehand. Discuss both the benefits of surgery and your breastfeeding concerns. Your surgeon can then perform the type of surgery that best preserves the structures needed to breastfeed. You may still find out afterward that you are unable to breastfeed fully. If so, remember that any amount of breastfeeding benefits you and your baby.

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