Breast Surgery

By Krista Gray, IBCLC. Last updated August 11, 2013.

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Breastfeeding Mother

Most every mother will be able to lactate following breast surgery, though whether lactation is full or partial depends on several factors.

More and more women are having babies after having breast surgery. Many of these women have a lot of anxiety wondering if they will be able to breastfeed following surgery.

Most every mother will be able to lactate, though whether lactation is full or partial depends largely on the type of incision(s), how much functional breast tissue remains, and the extent of damage to the nerves in the breast. The greater the time between surgery and lactation and the more lactation experiences the higher the likelihood of full lactation.

Excellent lactation management is also critical in maximizing breast milk supply. Even if a full supply is not possible, mothers who desire to breastfeed are usually able to develop a very satisfying relationship by supplementing in ways that maximize their milk supply and a baby’s time spent at the breast.1

Augmentation Mammoplasty

Breast augmentation surgery is done for a variety of reasons – small or asymmetric breasts, reconstruction after an accident or surgery, or for cosmetic reasons.  It is important to note the reason why a mother has had a breast augmentation because if the breasts were small and hypoplastic to begin with it may be that there wasn’t much glandular tissue (which is necessary for lactation).

However, the amount of glandular tissue in a breast is not always evident just by looking at the size or shape of a woman’s breasts and even small-busted women can have a full milk supply.  Excellent lactation support is critical though, with lots and lots of skin-to-skin time following birth and unrestricted access to the breast for the baby.  In the early days, mothers will often need to pump or hand express in addition to breastfeeding to help build as strong of a milk supply as possible.

As with all types of breast surgery, the type of incision can have a profound impact on a woman’s ability to breastfeed.  Periareolar incisions have a greater chance of damaging nerve tissues which are essential for breastfeeding, though implant size can also have a large impact no matter the type of incision.2  Many women have complications, which necessitate revision surgery. The more surgeries a woman has on her breasts, the greater the likelihood that functional breast tissue or nerves will be damaged in a way that will negatively impact lactation.

Silicone Implants

Silicone implants have had a lot of publicity with women believing that they cannot breastfeed because too much silicone will leak into their breast milk.  Actually, this is not the case at all.  Silicone is not readily absorbed in a baby’s body and is considered to pose little threat to a baby’s safety.3 Actually, studies have shown that silicon levels are vastly higher in infant formula than the breast milk of mothers with silicone implants.4

Breast Reduction Mammoplasty

There are a variety of reasons women have breast reduction surgery, including their physical and mental health, lifestyle, and/or cosmetic reasons. Very large breasts can cause chronic back pain, circulation and breathing problems, headaches, postural problems, and make an active lifestyle extremely difficult.  As with other types of breast surgery, the type of incision used and amount of functional breast tissue removed will have a direct bearing on future lactation ability.

Women who have the free nipple graft technique (the nipple is severed completely from the ducts and nerves and then grafted back in) have decreased chances of successful lactation compared with other surgical types.  Women having pedicled reduction mammoplasty usually have greater success in lactation.  It is important to note that complete loss of all sensation in a woman’s nipple and areola can prohibit lactation completely.5

Full lactation is not always possible following breast reduction surgery.  However, excellent lactation support from the very beginning can maximize a woman’s milk supply.  Skin-to-skin contact following birth and continuing as often as possible in the early days is important.  Nursing often and on demand following your baby’s early feeding cues is a must.  Pumping or hand expressing in addition to breastfeeding is important to help ensure an optimum milk supply.  Many times mothers find they need to supplement and the best way to continue bonding and encouraging their milk supply is to use an at-breast tube feeding device. With this babies are latched onto the breast, breastfeeding, stimulating a mother’s supply, and receiving additional supplementation through a thin tube taped to the breast.

No matter how much breast milk a mother is able to give her baby following breast surgery, any amount she produces should be celebrated!  There are many methods that can help increase production and, even if supplementation is necessary, most mothers can have a satisfying breastfeeding relationship with their babies.

Show 5 footnotes

  1. West, D. & Hirsch, E. (2008). Clinics in Human Lactation. “Breastfeeding after Breast and Nipple Procedures.” Hale Publishing:  Amarillo, TX.
  2. West, D. & Hirsch, E. (2008). Clinics in Human Lactation. “Breastfeeding after Breast and Nipple Procedures.” Hale Publishing:  Amarillo, TX p13.
  3. Hale, T.W. (2010) Medications and Mother’s Milk, 14th ed. Hale Publishing: Amarillo, TX.
  4. West, D. & Hirsch, E. (2008). Clinics in Human Lactation. “Breastfeeding after Breast and Nipple Procedures.” Hale Publishing:  Amarillo, TX pp14-15.
  5. West, D. & Hirsch, E. (2008). Clinics in Human Lactation. “Breastfeeding after Breast and Nipple Procedures.” Hale Publishing:  Amarillo, TX.