Can a person with a breast reduction breastfeed?
I had a breast reduction in 2004 and just recently had a baby. I was having so much trouble breast feeding that I had to stop. My lactation consultant said that too many of the ducts had been severed and although my breasts were making enough milk it was pooling inside and the baby was not getting it all. It was very, very painful but it was even more emotional.
Any one out there successful.
no
Sure – but it’s skim milk
yes
I’ve not had any breast surgeries myself, but I’ve known a few women that have…
the book “Defining Your Own Success; Breastfeeding After Breast Reduction Surgery” is a great read.
One woman in particular who came to our La Leche League meetings for a while used an SNS… supplemental nursing system… she used some formula and would use this to feed her child. She did have milk of her own, but not enough… so each feeding she would put a few ounces of formula into the SNS bag and would alternate breasts at each feeding. She estimated that on an average day baby was getting 50/50 breast and formula… and the baby was never introduced to a bottle… so she also did lots of comfort/snacking feeds. Ocassionally she’d be out longer than she’d planned and would not have packed enough formula, but even a “half meal” type of snack was enough to sustain the baby and keep her happy until they got home and could have a couple of more ounces of formula!! She worked long and hard to get to where she was, had her lactation consultant on speed dial, and never missed a LLL meeting for close to a year.
That book I mentioned is all about deciding for yourself how much is “enough” when you physically & medically cannot feed your baby 100% from your body. Even if you manage a 10/90 ratio of breast/formula, I’d say it’s worth it… plus the physical closeness even if you do not have any milk is worth getting an SNS and using it!
I know you recently had a baby… but it may be worth investigating further, not only with a lactation consultant, but especially if you plan on having any more children another surgeon to see if anything can be done as far as some “rerouting” of the ducts to avoid that pooling.
Being able to breastfeed after a reduction varies from woman to woman. As your LC told you, it can depend on how many ducts were severed, whether any nerves were also cut, and if any of the ducts have recanulated (grown back) since the surgery. You’re more likely to be able to breastfeed if the nipple wasn’t completely removed during the surgery. Some mothers can fully breastfeed, most often mothers have a partial milk supply. That doesn’t mean you CAN’T breastfeed, though. Any breastmilk your baby receives is beneficial, and breastfeeding is also about closeness and connection with your baby. Some mothers will choose to feed their babies any necessary supplement through a tube at the breast (a supplemental nurser). Any ducts that no longer have an opening through your nipple will have to stop producing milk, which as you found can be quite painful for a time, but this will pass (there are steps you can take to reduce the discomfort in the meantime). And many mothers find that they produce more milk with each baby, so just because breastfeeding was unsuccessful this time doesn’t mean it won’t work if you have another child.
It can be so devastating to not be able to feed your baby. It’s okay to grieve that loss. We’re very lucky to have access to formula and clean water, so we can feed our babies if breastfeeding doesn’t work. But you can still miss having that part of motherhood. And if you expected breastfeeding to be part of having a baby, it can be hard to let go of that expectation. The sadness and grief will ease with time, and as you get to know and enjoy your new baby.
Don’t give up! You should start again and get a better lactation consultant. Experts believe the more you breastfeed the more chance there is of the milk ducts “recanalization” that is becoming reconnected to the nipple. Now that doesn’t mean that every woman is capable of breastfeeding exclusively after reduction BUT any breastfeeding is worth it both for you and the baby.
Also breastfeeding isn’t just about nutrition. There is no reason not to let the baby suckle even if they weren’t getting any milk.
Any ducts that aren’t connected will not be emptied and should stop making milk over time. So over time you should, like other mothers, become less engorged.
http://www.bfar.org/faq.php
Recanalization
Recanalization is the process during which previously severed ducts reconnect or new ductal pathways develop. The most extensive instances of recanalization have been seen in direct response to lactation. Any duration of lactation seems to prompt the mammary system to reestablish new ducts. The extent to which recanalization will occur seems to correspond directly with the extent of the mother’s previous lactation experiences. A mother who had an incomplete supply with her previous baby may find that she has more milk with her next baby. In some mothers, recanalization has resulted in a complete milk supply for subsequent children. A slight amount of lactation tissue is also formed in response to the hormones that are secreted during each menstruation. Therefore, the longer the mother has lactated and the more menstrual cycles she has experienced, the greater the potential for recanalization, although lactation potential is limited by the extent of the surgery.
One other angle regarding what happens to ducts during surgery is how many ducts the mother actually has. It has recently been discovered that the number of ducts that actually open out to the nipple can vary much more widely than we have thought. Researchers found an average of nine ducts that came all the way through the nipple, but as few as four were also observed. A woman with nine ducts can afford to lose a couple, but a woman with only four really can’t afford to lose any. Though she may still have enough milk-making ability, if the milk can’t get out then baby can’t get it and that area of the breast will stop producing.
http://www.bfar.org/faq.php#possible
Q Is it possible to breastfeed after breast or nipple surgery?
A Yes! Depending upon the type of surgery that was performed, most women can produce some amount of milk. Every drop is greatly beneficial for your baby.
Breast reduction surgery tends to affect lactation capability the most, although augmentation, lift, diagnostic, and nipple surgeries also can reduce the amount of milk a mother can make.
We’ve found that far more women are forced to abandon breastfeeding in favor of exclusive formula feeding because no one around them knew enough about the issues involved to be able to educate them or fully support their efforts, than because they were physically incapable of producing milk. There are so many issues that surround breastfeeding after breast or nipple surgery and so many feelings that women who have had it can experience. It is seldom as easy a process as for women who have not had breast or nipple surgery. But if you are dedicated to providing the benefits of breastmilk and breastfeeding for your child, there are now many resources available on this website to provide the information and support necessary to enable you realize your breastfeeding goals.
If you do not have a full milk supply, it is important to know that many mothers breastfeed very successfully without a full milk supply by supplementing in ways that are supportive of breastfeeding. There are also many ways to increase milk production using a variety of methods that can include (depending on the individual circumstance and preferences) pumping, breast compression, deeper latching psychological conditioning, and galactagogues (substances that increase milk production).
When supplementation is necessary, some mothers supplement with at-breast supplementation products like the Medela SNS or the Lact-Aid, which are containers that hang around the neck with tubes that supply formula or pumped milk as the baby nurses from the breast. Using the at-breast supplementer is the ideal way to prevent nipple confusion and flow preference while maximizing milk production, but it does pose some challenges. It is not a device that works well for every every mother and baby, particularly when baby is not able to latch well or remove milk effectively.
For these and various other reasons, some mothers choose to use bottles to supplement. Contrary to the warnings about bottle use in the BFAR book and elsewhere, we now know that using them does not necessarily impact breastfeeding negatively. Many mothers have used bottles to supplement and have continued to have successful breastfeeding experiences. We now understand that there are ways to use bottles that minimize their impact. Click here for more information.
Realistically, it’s important to understand that not having a full milk supply and needing to supplement, while at the same time taking measures to increase milk production, can be a lot of additional work. However, it is certainly well worth the effort for the tremendous benefits of breastfeeding.
Q What is the definition of “successful breastfeeding”?
A Here is an excerpt from Defining Your Own Success: Breastfeeding After Breast Reduction Surgery:
“Among women who have had breast reduction surgery and are now breastfeeding, it is often said that “We each define our own success.” As it is used here, “success” is not an absolute term referring to a continuum of less to more milk produced. Rather, it is defined by the degree of satisfaction each woman and her baby derive from the breastfeeding relationship they create together. It is not determined by the amount of milk a woman produces.
Each woman’s experience of success will be different; some may be able to breastfeed exclusively, while others may need to supplement the baby’s entire nutritional requirement.”
It is also important to remember that nursing is so much more than nutrition. By breastfeeding our babies, we meet a whole range of emotional needs as well. When we understand success in this way, we are aware of the power we have to make breastfeeding possible and to be wholly satisfied with whatever unique direction our breastfeeding relationship may take. It is this empowerment that gives us strength in vulnerable moments and keeps the knowledge uppermost in our minds that we alone determine what success will mean for us.
I had a breast reduction in 1999, and had my baby 4 weeks ago. I had been breastfeeding exclusively, although my nipples are not large enough for my baby to latch on to and I have to use a breast shield every time I nurse. I had a feeling that my breasts were not producing enough milk however, as my baby’s weight gain is slow. I am now supplementing the breastfeeding with formula.
It can be done! It just depends on each individual surgery.
Yes they can.
http://www.bfar.org
http://www.breasthealthonline.com