Breastfeeding after reduction

[CocoK]

I had a breast reduction many moons ago and as a result I had a very limited milk supply the first time I gave birth. I expressed and expressed but there was so little in there - my milk never 'came in', or at least I don't think it ever did, and I eventually gave up after 5 weeks as it was too difficult to mix feed, especially as I had twins.

I'm now 35 weeks with a singleton and want to try breastfeeding again. Am (hopefully) wondering if my milk supply might be better this time since I've already done it once? I seem to have heard that the ducts/tissue can expand, but am not sure if this is rubbish or not...

I would be very interested to hear from anyone who has successfully breastfed after a reduction and/or found it easier the second time around.

The most important time for milk production is the time straight after birth. Go for skin-to-skin straight after birth (natural or c-section) and try to offer the breast within an hour of birth. Then make sure you bring baby to the breast as often as he/she wants. These first few days activate the milk glands to produce milk. the more stimulation they have teh more are activated. As your surgery may have damaged soem of teh glands/tubes it's very important to activate as many as possible!

I would also investigate getting some Domperidone on prescription when the time comes. It stimulates milk production.

Also, with just a singleton (I'm a twin Mum too expecting a singleton!!!), in theory, you should only need half the milk!! Plus you'll have the 1-to-1 time to help establish good breastfeeding practices!

My only experience of this as a breastfeeding peer supporter is a friend of mine, and she did only manage to mix feed. However, I'm not sure whether this was because of low milk supply or whether she would have ended up mixed feeding anyway, even without the breast reduction!

If you do have supply issues this time, try again with the mixed feeding. A lot of people do every other feed breast and formula and it's better than nothing!

I mixed fed from birth with both mine and definitely has more milk the 2nd time around. However I suspect this was more to do with tons of skin to skin (didn't get him dressed at all for about 10 hours after birth, just cuddled him naked with a blanket around us and fed as much as poss - was totally fab actually although midwifes kept asking when I was going to put a babygro on him ) I also asked GP for Domperidone which she grudgingly prescribed and hired an electric pump. First time around I was less confident and had done less research, just presumed I wouldn't be able to and was pleasantly surprised I had any milk at all (my op was 15 years ago and was told I wouldn't be able to at te time)
I also never had the whole 'milk coming in' thing, was waiting for boobs like boulders but it didn't happen!
I think its hard because nobody can give you answers re milk supply etc after a reduction, no way of knowing how much supply has been affected by the surgery so its just a case of giving it a go.
I have 2 other friends who have had reductions and both of them mixed fed too.
Good luck!

Hi CocoK - I had a breast reduction too and like you am on my second pregnancy. Unlike you I didn't try to breastfeed first time around, I decided on balance to ff from birth. But I've regretted that decision ever since and this time I do want to breastfeed.

To that end have purchased "Defining Your Own Success" by Diana West - the only book I've found on breastfeeding after reduction, which I think must be out of print here now so new copies are expensive. But you can get 2nd hand copies on ebay quite reasonably (mine was £13). Haven't read it yet though!

I've also registered on www.bfar.org - they have their own forum which seem to be quite well subscribed, there's lots of experience there you can draw from.

StopTalking is right - it's different for everyone and that lack of certainty can be frustrating.

Good luck to you this time around.

I am in a similar situation. Reduction about 13 years ago. During first pregnancy did some research including (partially!) reading "Defining Your Own Success" (as mentioned by lazyemma).

I didn't take Domperidone (but might look into it this time) but I took certain herbal supplements as soon as DS was born (I'll go back to the book to refresh my memory as to what they were - sorry can't remember!).

Was suprised and thrilled when DS latched on and started to feed. Unfortunately he was readmitted to hospital at 5 days old due to losing 15% of birth weight. Hard to know if due to restricted supply due to reduction, delay in milk coming in due to c-section or other issues (eg jaundice etc). I had some milk but not quite enough to get his weight back up to an acceptable level. I had to top up with formula when we were back in hospital - but was advised not to rely on top ups as my supply was getting there, and top ups would stifle it. Hard though, as I was so worried by then.

I ended up doing mixed feeding for about 11 weeks. I pretty much topped up after every feed which did ultimately kill my supply! As his needs increased, I ended up increasing the size of the formula feeds, If i'm in the same situation this time around (I'm 30 weeks pregnant with no. 2) I'd probably try BF for some feeds and bottles for others rather than doing top ups.

I did have milk, just probably not enough, and my god, I did get the boulder like boobs when it came it - I think that was half the problem, I should have maybe expressed some to relieve the pressure as I don't think the poor boy could get any out at that stage

I got on really well with the huge hospital pumping machine when we were back in hospital, but never mastered the hand held ones, so I'll try a bit harder with those (or hire a hospital grade one?) this time.

Really interesting to read all your tips and also to know that there are others with the same issues.

Thanks ladies - great to get such good advice and to know I'm not the only one. Will speak to GP about Dom Perignon drug - when do you start taking it, and does it have any side effects?

Am otherwise a bit worried about judgey comments/attitudes from people regarding mix (i.e. formula) feeding as I'm sure I'll have to use bottles some of the time. Last time I got off lightly I think as I had twins so nobody questioned the formula use. Am feeling quite defensive about it now though as I don't want to have to tell the world and his brother that I had a reduction to 'justify' not breastfeeding exclusively . How have you handled this issue - if it is/was an issue for you, that is? Maybe I'm just being pregnant and paranoid...

Wow, wouldn't that be great if large quantities of Dom Perignon increased milk supply. One can but dream!

Yes, I know what you mean - I was really paranoid and a bit defensive last time round re mixed feeding. Don't really have any advice, but just to say that I'm determined to just roll with it this time - if I can bf - great, if I can't, or I can only partially, then so be it - it is what it is. I remember thinking this when DS was about 11 months old and was munching on a corn on the cob - that I promised myself that I wouldn't stress so much next time, as he was clearly fine and anyway, those early weeks are such a small window of time.

It remains to be seen whether this zen like attitude will come into force post-natally! I think that last time, I made a bigger deal of it than anyone else did, so I'm going to try not to make it a big deal this time.

Having said that - that doesn't mean I'm not going to try hard - I'll try to master expressing, I'm going to see if I can see the bf counsellor at the hospital and I'm going to stock up on the herbal supplements (fenugreek, I think it was) again.

hi, no experience personally, but my SIL is feeding her 8 week old after a reduction several years ago.

She seems to have a great supply, baby putting on weight well. in fact, her supply seems much better than mine ever was/is!

sorry not much help, but might be good for some to read about a success story. Best of luck second (third?) time round. I have also heard about duct recanalising and bf being better in subsequent pregnancies, when i was doing some reading to support SIL.