Breastfeeding After Breast Reduction Surgery

Is it possible to breastfeed following breast reduction surgery? Absolutely! It can be a lot of work, and requires patience and the willingness to be flexible in our expectations, but breastfeeding after reduction surgery can also be a very empowering and rewarding experience. I share my story here so that other moms who have been through breast reduction can be inspired that breastfeeding is a realistic and achievable goal.

I had my first baby in 1995, and despite my best intentions, she was weaned by three months of age. I had always had extreme shoulder and upper back pain resulting from the size of my breasts, but after I had the baby, it only got worse. When she was six months old I chose to undergo breast reduction surgery. I asked my plastic surgeon about breastfeeding future babies - he told me that some women can, some can't (this is a common response, as surgeons typically have limited knowledge about breastfeeding).

The type of surgery I had was called the inferior pedicle technique. This is generally a favorable technique for future breastfeeding because the nipple and areola remain attached to some of the underlying tissue, as opposed to the free nipple graft, where the nipple/areola is completely removed and then sewn back on following the removal of tissue.

Unfortunately, I experienced a rare complication of the surgery - due to poor blood circulation after the breast reduction, my right nipple and areola lost blood supply and necrotized. I had a skin graft about two months post-operative, and obviously could not breastfeed on that side. Despite this traumatic complication, I continued on to create wonderful breastfeeding experiences with my next four children.

Prior to getting pregnant with my second child, I found an email list called BFAR - Breastfeeding After Reduction. The few initial members had fumbled along on their own, with little available information they had to invent ways to make breastfeeding after reduction surgery work. Over time, the list grew and we all worked together to discover and develop new ways to improve our breastfeeding efforts. That list has since moved to a forum setting at http://bfar.org, along with a plethora of other useful information related to breastfeeding after different types of breast surgery.

Prior to the birth of my second baby - my first breastfeeding after reduction baby - I learned about Domperidone (generic name motilium), which is a drug used in other countries for acid reflux. A side-effect of the drug is increased lactation. Motilium is categorized as a class B drug, making it relatively safe with few known dangerous side effects and minor passage to the baby via breastmilk.

During this time I also learned from other breast reduction moms about the existence of supplemental nursing systems such as the Lact-Aid and the SNS. Both of these systems are comprised of a container for formula or donated breastmilk, attached to tubing that goes into the baby's mouth along with the nipple. The Lact-Aid's containers are disposable plastic bags, making them slightly more discreet when nursing in public; the SNS uses a rectangular plastic bottle. I ordered two Lact-Aids, a supply of Domperidone in addition to fenugreek, blessed thistle, and other herbal galactogogues.

When my son was born, I immediately began the Domperidone and herbs and attempted to breastfeed exclusively. It was clear within a few days that he wasn't getting enough milk, so I added the supplementer. Once we moved past the initial frustrating phase of the learning curve with the Lact-Aid, everything smoothed out and we continued to nurse happily until he was 17 months old, after my third baby was born.

My daughter experienced some reflux, which complicated things. She would spit up a lot, so keeping supplement in her was difficult. We persevered and at four months I began supplementing her with formula slightly thickened with baby cereal, which allowed us to discontinue use of the Lact-Aid - this made things more convenient, especially when nursing in public.

I weaned baby number three at age 22 months, when it became too painful to nurse during the current pregnancy. My fourth child was born four months after that, and I breastfed her until 22 months as well, giving up the Lact-Aid for solids around six months. My last pregnancy also came during that time, and my youngest child was born when the number four was almost two years old. I did use the supplementer at first with him, but unfortunately we were undergoing some stress when he was about six months old, then we moved and in the chaos I ended up bottle-feeding him and he weaned by eight months.

All told, using Domperidone and herbs, I was able to provide between 60-75% of my babies' breastmilk needs. It is common for moms breastfeeding after reduction to have more milk with each subsequent baby, sometimes being able to exclusively breastfeed eventually. A few moms are able to breastfeed exclusively from the beginning, however this is not the norm.

Whatever amount of milk a mother is able to provide after surgery is precious and nutritious for baby. The nursing relationship alone is extremely beneficial and should not be underestimated. Breastfeeding following breast surgery can be frustrating and difficult at times, but in the end it is an effort of which a mother can be proud and is worth all the challenges along the way!