Adoptive Breastfeeding

Breastfeeding My Adopted Baby

Mary Straits HeadshotKaren Lytle is the mom of four kids so far, three biological and one handsome adoptive son.  She has had the amazing privilege of breastfeeding all four of them, including her adopted son. Karen’s story is as unique as each mother’s breastfeeding journey, but she shares it hoping that some of it helps to inspire other adoptive moms as to the wonders of intimacy that can be a part of nursing adoptive children.

When our oldest was 15 months old, we brought home two beautiful, identical twin girls. Life was busy, but good. I was learning the joys and challenges of nursing multiples. When the girls were 6 weeks old the Lord told us it was time to start a process of adoption. We had always known we would adopt, but he told us the time was now.

We explored foster care, international, but in the end for this time, God was leading us to adopt a newborn – one who fit the qualifications of “more difficult to place.” We were matched when the girls were 14 months old, and Isaac’s birth mother was 37 weeks pregnant. I was still nursing the girls twice a day at this point, and I started weaning them the day after we met Isaac’s birth mother. As I weaned them, I began to pump every 1 1/2-2 hours including a nightly pump to get ready for the demands of breastfeeding my adopted baby.

Adoptive Breastfeeding

I had always struggled with low milk supply issues, so I think like every adoptive mother who tries this, I went through all of those concerns of whether or not I would be able to produce enough milk. But I was determined to teach him to breastfeed. So, I began to research, and I put myself on a nursing mother’s diet. I drank barley water and ate a variety of foods and spices (such as anise) that helped to nourish my milk. I also took fenugreek and blessed thistle supplements.

We brought him home when he was two days old. And I still remember that night. I told my husband that I wanted to have that first night where it was just Isaac and me so that I could be totally relaxed and work just with him on his feeding while he was sleepy and just get him used to my heartbeat. I stripped him down to his diaper, and laid him on me skin to skin. Every time he stirred, I would offer him my breast, and within a few offers, he had latched on just suckling instead of nursing. But, by the end of that first night, he had nursed twice. We slept together skin to skin, or I should say dozed together, like this for about a week. And he rarely wore any clothes during those first days together. I wrapped him up next to my skin and held him almost the entire time.

Adoptive babies need to acquaint themselves with their adoptive mother’s heartbeat, scent, and touch. With a biological newborn there are changes outside of the body, but there is an instant connection with sounds and sensations when their biological mother holds them.

With an adoptive infant, those connections need to begin to form with that new adoptive mother’s heart rhythms and touch. While there is no physical memory at this point, a child still has something called cellular memory. So, imagine this as a time where you are helping them through a grieving process that they don’t even know they have.

Also while helpful for every infant, light infant massage can be especially helpful for an adoptive infant’s transition into your family. It has also been proven to heal and correct any sensory pathways that might have received slight damage due to stress in utero or stress during delivery.  For an adoptive infant there is the added stress of separation from their biological mother.

Big brother with adopted baby.

Big brother with adopted baby.

Now, truthfully, nursing wasn’t a perfect process. While he was nursing like a champ, I have always struggled with low milk supply, so we did supplement some. And the most difficult time nursing him actually came when he was about 3 months old. I had emergency surgery and was in the hospital for four days, and while I pumped, I couldn’t nurse him. Fortunately, my sister had just had a baby, and so while I couldn’t nurse him she was able to.  But, by the time I got out, my milk supply had dropped even lower.

I met with a lactation consultant two days after I came home, and for the next 2 weeks, I used an at-breast-tube-feeding device when I nursed him. I think the amount of pain I was in and my stress that I might not be able to keep nursing him was affecting my supply. But, we made it through that, and I was able to nurse him until he was a year old.

I hope this inspires other adoptive mothers. This is a precious time with your child; relax and do everything you can to make it happen. You will not regret it. Nursing builds intimacy and trust between a mother and child.

Adoptive BreastfeedingWhile it is their best nourishment for their body, it is also building their emotional well being, and promoting their brain development beyond just nutrition as well. And when you are nursing your precious infant, especially your adoptive infant, remember to use it as a time to look deep into their eyes.

There is a reason the eyes are called the windows of the soul, and science has proven that those moments of eye contact between a mother and child in those early years provides a foundation of trust and connection that supports them for years to come. And for an adoptive infant, these times are being built at placement rather than before, so by doing this you can recoup some of that
lost time.

Breastfeeding After Reduction: A Mom’s Journey

Krista Elliott HeadshotKrista Elliott is the mother of two little boys, aged 4 years old and 9 months, and is currently on maternity leave from her job as a regional communications coordinator for a multinational conservation organization. Connect with her on Twitter @Quackerflack.

Women have a strange relationship with their breasts. Some love them. Some hate them, and some, like me, have a relationship that is storied and not a little complicated. I was what is euphemistically called an “early bloomer”, meaning that I wore my first bra at age nine. No training bra, though. My breasts needed no training. They were already close to a B cup by this point. I soon outgrew the B cups, roared past C, D and DD, to eventually settle on the unheard-of (to me) size of 38G.

I hated them. My breasts overwhelmed my average frame. Buying bras and bathing suits often frustrated me to the point of tears. And it goes without saying that I received a lot of attention from boys, and that the attention was entirely the wrong kind – the kind that confuses and overwhelms a 14-year old girl just learning to navigate her sexuality and the self-esteem issues that are often tangled up therein. I could not run or play sports. I quit the swim team. More alarmingly, my shoulders started to round and my posture started to suffer. I wanted a breast reduction.


Photo courtesy of Wonkyeye Photography.

Fortunately, I live in a country with universal health coverage, and my reduction was considered medically justified. So cost was not an issue. We met with a surgeon, and asked many questions: healing time, loss of sensation, when I could resume activities, etc.

We never asked about breastfeeding. It didn’t occur to my 16-year old self, nor did it occur to my mom, who had had her babies in the 1970s, when formula feeding was pretty much de rigeur. I just wanted to have normal-sized breasts, and babies were the last thing on my mind.

The surgery was a success, and I moved on with my life and my much more manageable-sized breasts. The hate was gone. I now adored my perky, perfect C-cups. I went to university, graduated, worked, fell in and out of love, and eventually, at age 26, met the man who would become my husband (and who would actually change my previous “no kids” plans).

2013-05-13 13.12.56

At 33, we decided to start a family. Suddenly, I wondered…could I breastfeed? Would it be worth a try? With a fierceness that surprised me, I realized that I very much WANTED to breastfeed. I wanted to nourish my baby from my body and I wanted the baby to have all of the benefits of breastfeeding. I wanted it to work. I ordered “Defining Your Own Success”, and read it cover to cover, dog-earing dozens of pages.

I thought I was ready to make it work. When my breasts started leaking colostrum at week 36, I shrieked for joy. Sam was born in August of 2009. A beautiful little boy, delivered after an induction, an epidural, and intervention after intervention. I was determined to nurse him, and being in pain from the episiotomy, I figured that nursing him lying down would work. And it did.

We got a semi-workable latch, and I could see his tiny ears moving as he swallowed that precious colostrum. We were on our way! Doubts and trouble crept in, though. A well-meaning nurse gave him a bottle. Another nurse basically bullied me into trying a cross-cradle hold while sitting in a rocking chair, bringing me to tears of frustration.

I was getting conflicting advice from everybody, and became confused and bewildered. It only got worse when I got home. I just wanted to nurse (and pump, to build my supply), but was still too bashful to nurse in front of anybody but my mom and my husband. And yet, visitors kept coming to see the baby.


The doorbell rang all day long. I was too shy to nurse or pump in front of these well-meaning aunties and uncles, but where they’d come to see the baby, I couldn’t very well disappear upstairs with him either. I stewed and stressed and cried about it, and just wanted everybody to go away. My doubts were further exacerbated by my own hungry baby. I’d nurse Sam for a half-hour, and then offer him a bottle to top him up. He’d drink all four ounces, convincing me that he’d gotten absolutely nothing from my breasts.

My love for my breasts had turned into a sort of tired disgust. Sure, they looked good, but as far as I was concerned, they were useless. This went on for 6 weeks, until I finally threw in the towel. He went onto formula and bottles, and I put my nursing bra away and returned my rented breast pump. I was disappointed, but also relieved that the ordeal was over.

No longer stressed out, I could enjoy Sam and bond properly with him. 3 years later, I became pregnant with Alex. A bit older and a bit wiser, I was determined to not let fear derail me. At my first prenatal visit, I told the doctor that I wanted a prescription for Domperidone. I knew that herbs alone would not be enough, and wanted every possible bit of help. I also ordered a Lact-Aid supplemental nursing system, to supplement at the breast, which would help my supply much more than bottles would. Being realistic, however, I bought a case of concentrated formula.

cutieAlex’s birth was the polar opposite of Sam’s. My labour was unmedicated and quick, with him being born just 5 hours after my water broke. I looked at my little boy with his ridiculous shock of black hair, and remembering all the lessons I had learned from Sam, carefully latched his tiny mouth onto my nipple, where he clamped on like a small crocodile and drank greedily. The nurses marvelled at how beautifully he latched. I smiled ruefully, knowing that the only reason the latch was so good was because I had taught myself how to do it, during those tearful nursing sessions with Sam.

Armed with my Lact-aid, Domperidone, fenugreek, goat’s rue, and a mastered football hold, Alex and I were on our way. My goal was to not have to supplement more than 50% of his intake. My fear of nursing in front of others had been replaced by a complete lack of damns given about who might see my breasts. I nursed in front of my in-laws and other visitors.

I bought an “udder cover” and nursed in public, using that until I mastered the art of the discreet latch. A friend from a Facebook nursing support group gave me the tip of wearing a snug camisole under a loose top, and lifting the top, lowering the cami, latching the baby, and then draping the top. Shortly after that, I gave the nursing cover away.

I nursed at McDonald’s. I nursed at the park. Would you could you nurse in a boat, with a goat, in the air, everywhere? Oh yeah. Definitely. I nursed him in the football hold, the cradle hold, the cross-cradle hold, and even upright in the Ergo. We were PROS at this thing! One day, I realized that Alex was only drinking about 3 ounces of formula a day. I stopped cold, my mind reeling. Could I do it? Could I exclusively breast-feed? I hadn’t even considered it, any more than I had considered sprouting wings and flying.

2013-04-12 14.22.16It seemed impossible for a BFAR mom to exclusively breastfeed, but we were SO close…so very close. I figured going a few days without formula wouldn’t starve him and taking a giant breath (and a couple of extra doses of goat’s rue), took the leap of faith.

I watched Alex’s weight closely. Would he lose weight, confirming the need for formula? Or would he hold steady, or even gain? I remember looking at the scale with joyful tears in my eyes when I realized that he was gaining weight. My baby was gaining weight off of ONLY my breast milk.

I wanted to stop strangers in the street and shake them by the shoulders and tell them what I had accomplished. I wanted to take out ads in the newspapers. I wanted a damn medal. I was doing it! I was exclusively breastfeeding my baby, and he was gaining weight!!! I had succeeded beyond my wildest dreams. My breasts were now beloved.  Older and a bit tattered, but full of priceless treasure.

I would stare at my baby, marveling, as he latched on and drank, looking up at me with the heart-swelling trust that an infant has in his mother. Alex is now 9 months old, and has been on solids for a few months. He is pulling himself up on the furniture and trying to eat everything in sight. He’s in the 50th percentile for weight and the 90th percentile for height. He still gets the odd bottle of formula if we go out for a date night or if his cluster feeds have rendered my breasts in need of a break.

But I give him formula on MY terms, not on anybody else’s, and not because I feel I have to. Most days, he still drinks only my milk. And I still stare at him in wonderment as he drinks, as this precious, beautiful little boy takes his nourishment from my body. From my breasts. From me.

Adoptive Breastfeeding

Adoptive Breastfeeding

There is an increasing trend today of mothers who are interested in breastfeeding their adopted children.  Breastfeeding, in general, is on the rise in western cultures and many adoptive parents don’t want their infants to miss out on either the nutrition or bonding that nursing provides.  Whether the child is a newborn or toddler, many adoptive parents are researching what it takes to be able to breastfeed when it’s not a mother’s biological child.

Important questions to consider

There many factors that must be considered:

  • Has the mother ever breastfed a child?
  • If so, how long has it been since she nursed a child?
  • How long did she nurse the child and why did she wean?
  • How much time does the mother have until she will receive her baby?  ie does she need to begin lactating immediately or does she have time to prepare her body hormonally?
  • How old is the baby to be adopted?
  • Has the baby ever nursed before? What is the likelihood of baby latching to breast?
  • What are the mother’s goals – full breastfeeding, partial breastfeeding, comfort at the breast, nursing at the breast with at-breast tube feeding device, etc.?
  • Does the mother have a supportive network around her?

Frequent breast stimulation and milk removal are critical

Even when an adoptive mother has never had her own biological children, it is possible to induce lactation and breastfeed a child. There are many things that are important for success with adoptive breastfeeding, but, if a mother wants to nurture her child at her breast with milk (rather than just comfort nursing and snuggles) then frequent breast stimulation and milk removal are critical.

It doesn’t matter what else a mother does – hormones to mimic pregnancy, being surrounded by a supportive network of friends and family, skin-to-skin contact with baby, galactagogues to increase milk production, etc. – if the breasts are not stimulated at regular intervals throughout the day and night and milk effectively removed once production begins, then a mother’s body will not build a milk supply.  Frequent and effective milk stimulation and removal are essential!

How can a mother who hasn’t given birth make milk?

Hormones in pregnancy prepare a mother’s body for breastfeeding.  Breast milk is kept in check by progesterone.  When a mother delivers the placenta her progesterone levels dramatically decrease and the body begins to rapidly make milk – which a mother notices as her milk “coming in” between days 2-5.

However, the mammary glands can also be stimulated by suckling – with a baby, breast pump, or hand expression – which facilitates the growth of mammary tissue and release of hormones essential for lactation. Frequent suckling is what allows this process to continue.

Keys to successful lactation

  • Maternal motivation
  • Support system surrounding mother including supportive partner and mother-to-mother breastfeeding support group
  • Excellent breastfeeding counsel from a qualified lactation consultant
  • Baby who can effectively suckle at breast or pump/hand expression system
  • Frequent and effective milk stimulation/removal…remember, an empty breast makes more milk.

Things to be aware of:

  • Oxytocin, one of the hormones essential to lactation, can be inhibited by stress.  Make sure to have a tribe of support surrounding and encouraging you!
  • If you have breastfed before, the longer the gap since this experience, the longer the time it will take for milk stimulation1 But, even if you have never breastfed, inducing lactation is completely possible!
  • Babies younger than 2 months are more likely to suckle on the breast naturally2
  • Babies and toddlers of any age can learn to breastfeed.  In fact, many infants who have never breastfed may initially refuse the breast.  This doesn’t mean they always will though.
  • Children who were breastfed before adoption may naturally seek the adoptive mother’s breast as well.
  • Some mothers will achieve a full milk supply while others will not.  Even if a mother doesn’t make enough milk for exclusive breastfeeding, she can exclusively feed her adopted baby at the breast through an at-breast tube feeding device.
  • It can take weeks to begin to see the first drops of milk once frequent, effective breast stimulation occurs.
  • Milk typically creeps in – as opposed to a mother’s milk “coming in” following birth where she may experience engorgement
  • Having a support system around you cannot be overestimated!  Having family and friends that can support and encourage you as well as getting involved in a local mother-to-mother breastfeeding support group are critical to your success.  There will be moments when you wonder why you are doing all of this and having others to encourage you and share their experiences will help you tremendously.

You may also be interested in reading 5 Challenges Adoptive Mothers Face with Breastfeeding as well as How to Encourage your Adopted Child to Breastfeed.

Insufficient Glandular Tissue

Glandular tissue is necessary for breast milk production.  The size of a woman’s breasts does not determine how much milk the breasts can make; it is the glandular tissue within.

Though a woman with small breasts will most likely need to feed her baby more times each day to produce a sufficient quantity of breast milk, both large-breasted and small-breasted mothers can produce enough milk for their babies over a 24-hour period.

How many mothers have IGT?

An extremely small number of women will have a clinical diagnosis of insufficient glandular tissue (IGT). Research shows that approximately 1 out of every 1000 lactating mothers have IGT.1  Also known as breast hypoplasia, these are breasts that are underdeveloped and do not have sufficient glandular tissue to meet the complete milk supply her baby requires.  There are certain characteristics that mark hypoplastic breasts.

What are they symptoms of hypoplastic breasts?

Breasts come in all different shapes and sizes.  In fact, breasts on the same woman are usually different from each other!  There are some common characteristics of hypoplastic breasts, though a woman does not need to have all of these traits:

  • Extremely small breasts
  • Tubular shaped breasts
  • Unevenly shaped and widely spaced breasts
  • Very large areola

Does a diagnosis of IGT mean I cannot breastfeed?

A mother with hypoplastic breasts will usually still be able to breastfeed, though the amount of milk each woman is able to produce will vary.  While there is no way to know how much milk a mother will produce until she has her baby and tries to breastfeed, there are many things a mother can do to optimize her breast milk production.  The more the breasts are stimulated and milk is removed the more milk a body will make.  Excellent lactation support following birth is essential in maximizing supply.

The early days and weeks following birth are when a mother’s body is laying down the prolactin receptors that will dictate how much milk she is able to produce daily over the course of lactation.  Optimum milk removal during this time will help her body maximize what it is able to make.  Breastfeeding often and effectively is critical.  Your baby will need to be watched closely for weight loss, and supplements (whether donor milk or formula) should only be given if necessary.  If supplements are required, giving them with an at-breast tube feeding device is ideal as your baby will continue to suckle the milk in your breasts, stimulate your supply, as well as take in extra calories.

If you are concerned about your breasts having insufficient glandular tissue, it is best to meet with a lactation consultant (IBCLC) while you are pregnant.  Together you can develop a breastfeeding plan for your specific situation.

Tube Feeding Devices

There are a variety of tube feeding systems that allow mothers to supplement their babies while nursing at the breast.

Who Should Use an At-Breast Tube Feeding Device?

Tubing can be run to both breasts for tandem nursing or twin nursing. Photo courtesy of

Tubing can be run to both breasts for tandem nursing or twin nursing.
Photo courtesy of

These devices work well for babies who are able to latch effectively to the breast.  They are an excellent choice when a mother is attempting to increase her milk supply while breastfeeding her baby. They are also valuable when a mother must supplement but wants her baby to have the benefits of nursing – cuddling, bonding, skin-to-skin contact, proper oro-facial development, etc. Examples of situations where mothers have successfully used at-breast tube feeding systems include relactation, induced lactation, adoptive breastfeeding, nursing after breast surgery, in place of pumping to help increase low milk supply, when a baby is breastfeeding but must also have a supplement such as with PKU, in place of giving a supplement in a bottle, and more.

How Does a Tube Feeding Device Work?

This type of supplementation system consists of a container to hold the supplement (whether expressed milk, donor milk, or formula) and then thin tubing protruding from the container to the mother’s nipple. The tube is held in place by a nursing bra, nipple shield, band-aid, or hypoallergenic tape. Many moms prefer a band-aid as they can slip the tubing on and off and just leave the band-aid on their skin.  Care should be taken to ensure tube does not extend past the mother’s nipple so baby does not learn to suckle only the tube. The tube can be secured to the top, bottom, or either side of the areola – whatever garners the best result for baby. The tubing is typically inserted under the upper lip and enters the baby’s mouth along the roof of his mouth/palate.  However, some baby’s prefer the tubing to lie on the lower lip or along the tongue. Experimenting with what works best for you and your baby is key.

Baby Using Tube Feeding Device

Tubing can be secured to the breast with tape, if necessary.
Photo courtesy

The supplement can be initiated as soon as a baby begins to suckle at the breast, or the supplement could begin to flow after the breast has been drained. The tubing can be used in conjunction with a nipple shield.  For a baby with a weak suck, it is even possible to put the tubing from both sides on one breast so baby can receive an even larger quantity of supplementation while suckling at the breast. The flow of the supplement can be controlled by blocking and unblocking the flow of the tubing.

How Do You Clean the Tubing?

After each feeding, the tubing should be rinsed with cold water, then filled with warm, soapy water that is squeezed thoroughly throughout the tubing. This soapy water should then be rinsed well.  Once every day (24 hours) the tubing should be boiled for 20 minutes. 1

What are the Benefits of Supplementing with this Method?

As baby latches to breast, the tubing gently enters his mouth.

As baby latches to breast, the tubing gently enters his mouth.
Photo courtesy

At-breast tube feeding devices have many benefits:

  • Allows baby to continue nursing at the breast, rather than switching between bottle or other device which may lead to nipple confusion or breast refusal
  • Allows mother to breastfeed while supplementing with the added benefit of baby stimulating a mother’s milk supply while nursing
  • It is temporary aid to allow a mother to increase her milk supply while continuing to provide adequate nutrition to baby in a natural way
  • Mother can control rate of flow of supplement as well as starting the supplement later in the feed once breast has been emptied, or vice versa
  • A great option for mothers whose ultimate goal is to have baby nursing at breast
  • A great solution for mother’s who do not have enough breast milk to exclusively nurse but want their baby to experience full breastfeeding

When Should At-Breast Tube Feeding NOT be Used?

When a baby is not able to latch effectively to the breast, this type of nursing system is not very effective.  (In this case, working with a lactation consultant, it may be preferable to initially use finger feeding with the tube.) Babies can learn to suck the tubing, rather than the breast, in which case it does not help to stimulate a mother’s milk supply.  And when a baby is not able to generate sufficient suction at the breast, he will not be able to suck effectively enough to gain the nutritional benefit he needs.  If feeds take greater than 30 minutes, baby falls asleep during a feed, or if baby fails to gain adequate weight this type of feeding system is probably not the best option.2

Where Can You Obtain a Tube Feeding Device?

The supplement hangs in a pouch around mother's neck as baby nurses. Photo courtesy

The supplement hangs in a pouch around mother’s neck as baby nurses.
Photo courtesy

Two commercial tube feeding devices are sold in the US: SNS (Supplemental Nursing System) by Medela and Lact-Aid. Both can be purchased on-line and through many local doctors, hospitals, and lactation consultant offices.

The SNS by Medela has a firm feeding bottle, whereas the Lact-Aid has a soft plastic bag for the milk supplement.  The Lact-Aid requires a baby to suck against the flow of gravity as the tube exits from the top of the pouch. This may help to strengthen a baby’s suck, or it may be challenging for a baby with an already weak suck. 3

It is also possible to make your own at-breast tube feeding system. A gavage setup with a No. 5 feeding-tube or tubing from a butterfly needle can be used. 4

Breast Surgery

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.