Breast surgery and breastfeeding

If you are currently considering breast surgery, you are strongly advised to wait until you have weaned your last child before going under the knife; not only can surgery affect your ability to breastfeed, but pregnancy will affect your breast shape and size anyway.

However, if you have already had surgery and are now wondering whether or not you will be able to feed your child naturally, we look at the issues experienced with each type of surgery.

Breast augmentation

If you are thinking of breast augmentation – that is, increasing your boobs with an implant – you are strongly advised to wait until after you have weaned your last child. However, if you have already had an implant and are now considering breastfeeding, your success is likely to depend on the type of surgery you had.

If the incision was made under the fold of the breast, or via the armpit, then it should still be possible. The problem with breastfeeding usually occurs when the incision has been made around the areola, as the nerves and milk ducts may well have been damaged in the process. If you still have good feeling in your nipple, the chances are that you will be able to breastfeed, however you won’t know for certain until you first try to nurse.

Women with breast implants who are able to feed their child have an increased chance of mastitis and extra breast engorgement at the start. Ask your lactation consultant for advice on techniques and ensure your doctor knows of your surgery and monitors your baby’s weight progress closely.

Breast reduction

A breast reduction involves removing excess fat, tissue and skin from the breasts and, to some extent, your ability to breastfeed depends on how the surgery was performed. If your nipple and areola remained attached to the breast tissue during the procedure, and if you still have feeling in the nipple, then the likelihood is that you will be able to nurse your child. If, however, the nipple was completely removed and reattached, then the damage to the nerves could leave you with limited sensation which would not stimulate the milk flow.

If the surgeon only had to remove a small amount of tissue and did it carefully so as to leave the milk ducts, blood supply and nerve pathways intact, then the chances are you will be able to produce milk. If these structures were not maintained during the surgery, then you might struggle to breastfeed. Also, if you had a lot of glandular tissue removed, you may still be able to feed, but perhaps not produce a full supply.

You will not know whether or not you can breastfeed until you try, but you can also contact your surgeon to ask about your operation and seek advice from your lactation consultant. You should always let your doctor know about your surgery so that your baby’s weight can be closely monitored. If you are able to produce some milk you can create extra stimulation through pumping or by using a supplemental nursing system, and you can always top up your baby’s diet with formula.

Breast lift

This procedure is commonly performed after childbearing to combat the natural breast droop experienced during pregnancy and after breastfeeding, but if you have had a breast lift already, it is highly likely that you will be able to breastfeed. The surgeon effectively restructures the boob by removing pleats of excess skin and remodelling the shape into a tighter cone – as only skin is removed, there shouldn’t be any damage to the nerves or milk ducts and therefore breastfeeding should still be possible. However, as with any surgery, there are always risks and you may find that you have a slightly reduced milk production as a result.

Mastectomy and breast reconstruction

This is the procedure performed on women who have had a mastectomy, or large lumpectomy, as a result of breast cancer. It is not possible to breastfeed from a reconstructed breast, however most women are able to successfully produce milk from the other breast as normal. It is usually possible to breastfeed after a lumpectomy, so long as the surgeon cut as few milk ducts as possible and only tissue was removed.

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