Breastfeeding after breast reduction

[Mcmcmcmc]

I’m 19 weeks pregnant and starting to think about breastfeeding. I know it’s not easy for many women but apparently it’s harder (or, in some cases, not possible) if you’ve had breast reduction, particularly if it involved cutting around the whole circumference of the areola.

I’m 37 and had breast reduction 20 years ago. At the time the surgeon told me about the risk of it affecting breastfeeding but he minimised it a bit (saying that there was “no guarantee” a woman would be able to BF even without surgery) and to be honest I was 17-18 and didn’t really think much about it.

I’m a doctor (not obs&gynae or breast specialist though!) so I started doing some research on this. It seems that some women are able to BF but not exclusively - which I would be fine with. And the chances of being able to BF get better with time after surgery as your nerves and blood vessels supplying the nipples can regenerate. I lost all sensation on my nipples for a few years after surgery, but part of it came back, and I can feel touch and pain, but not temperature.

I’d love to hear experiences of others who also had breast surgery and tried to BF after. How did things go for you?

I’ll be booking an appointment with a BF consultant when it gets nearer my due date, but I would appreciate hearing others’ experiences thank you

[Justa47]

@Mcmcmcmc

You had a reduction at 17?

[Dowermouse]

I haven't, but wanted to wish you well.
Milk Matters is an amazing lactation consultant jsut incase yours is unsatisfactory.
Have you come across a SNS before as a way of feeding a baby at the breast when there isn't sufficient supply?

[elliemara]

Definitely speak to an IBCLC (certified lactation consultant). They are so knowledgeable and will be able to help much more than some less specialised doctors.

[Mcmcmcmc]

@Justa47 I started the assessment process just before I turned 18, and had the surgery at 18.

[Mcmcmcmc]

@Dowermouse thank you I just came across information about SNS, wasn’t aware of it before. It seems like a wonderful idea.

[Mcmcmcmc]

Bumping this to see if others have any experience or knowledge to share on this issue...

[FakeFruitShoot]

breastfeeding.support/breast-surgery-and-breastfeeding/ is a good place to start

[Branleuse]

If you had a reduction, then a lot of the breast tissue and milk glands will have been removed. The glands to the nipples will have been damaged. Theres a high chance that you wont be able to fully breastfeed even if you are able to produce some milk. This should have been explained to you as one of the consequences of the surgery.
Theres no guarantee you would have found breastfeeding straightforward even without surgery, that is true, but with breast reduction surgery its very unlikely.
I would probably assume that youll need to formula feed, and try and make peace with that.

[Mcmcmcmc]

Thanks @Branleuse yes it was explained to me at the time that it might be difficult to breastfeed in the future. I don’t regret the surgery as it made a very positive difference for me in my posture, pain reduction and general well-being, but at 18 I thought I would never want to BF anyway (mixture of misconceptions about BF and the certainty of decisions of an 18 year old ).

I have plenty of breast tissue left, my breasts are about a C-D cup after surgery and have been growing and swelling during pregnancy. What I have no way of knowing now is whether my ducts (at least some of them) remained intact. I will find out after baby is born, but in the meantime I am looking for experiences from others who were/are in a similar situation. I know there are no straightforward answers or absolute certainties on this matter!

The scenario I’m hoping for is that I will be able to feed my baby colostrum and then go on to mixed BF, feeding expressed milk and formula-feeding until baby is at least 6 months.

@FakeFruitShoot thank you for the link, it’s really helpful!

[Branleuse]

I hope it works out for you OP. I guess you wont know until youre there. I think you can hire lactation consultants who could help you find ways to make it work, even if its mixed feeding.
Ive had breast uplift but didnt do it till after id had my kids and knew i wouldnt need them for feeding. Formula feeding is fine too though.

[Moorelewis]

I had a reduction from a GG to an E cup at 18. Unfortunately I don't have a full supply, I made about 3- 400ml a day for my first child DS who I expressed milk for and combined with formula. I'm guessing that I make about the same for my DD. I think it's better to be realistic and not expect a full supply. I was told it's really unlikely to get a full supply after a reduction, especially if blood supply to the nipple was cut at any point during the operation. Obviously some breast milk is better than none. For the first few weeks with my DD I had the task of breastfeeding, expressing and then feeding expressed milk and finally offering formula. It is hard work but gets easier. Its worth seeing if your gp will prescribe domperidone off label. It really helped boost my supply. Good luck OP!

[eatentoomanygrapes]

@Mcmcmcmc Just wanted to check in and see whether you were able to BF in the end!

[Mcmcmcmc]

Hi @eatentoomanygrapes thanks for checking in! Unfortunately I was not able to BF my baby. I had a tiny amount of colostrum and BF was extremely painful, so the midwives on the postnatal ward offered me formula as my baby wasn’t able to get much out of my breasts.
I tried again once the milk started coming in - I got engorged and had to express to avoid mastitis. Again it was extremely painful and having her try to latch made me cry in pain every time. I had a few online consultations with a lactation consultant but after pumping just 60 ml in a 1-hour pumping session I realised my supply was too small to make pumping work. Having the baby on my breast was not an option anymore at that point as clearly the pain was too much. Perhaps this was partly to do with her latch, but I couldn’t face trying for much longer.
She’s been exclusively formula-fed from the beginning, except for one 60 ml bottle of expressed breastmilk, and is doing great. It made me sad that I wasn’t able to BF her but after a few days I came to terms with it.
There is a lot of negativity about formula feeding around, I had to learn to separate what information was helpful to what wasn’t.

[eatentoomanygrapes]

@Mcmcmcmc Thanks so much for your reply!

Ah, that must have been a difficult journey, but it sounds like you were prepared for the eventuality so it wouldn't have been a shock like I suppose it can be for those who haven't had a breast reduction.

I had mine reduced about 17 years ago so I'm hoping for the possibility of combination feeding... but I'll be fully expecting to not be able to. Anything else is a bonus I guess.

I've actually read a lot recently about how there isn't much data to suggest that "breast is best" -- and I'm sure there are other perks that we must consider, namely that our boobs will maintain their shape! And that partners can take on a lot more of the feeding!