Breastfeeding After Breast Reduction Surgery

There is a common misconception that you cannot breastfeed following breast reduction surgery, so I am here to share my alternative experience. Let me start by sharing why I decided to undergo this surgical procedure, even though I knew how important breastfeeding would be to me. When I was in chiropractic school in 2015, I finally made the decision to undergo breast reduction surgery, or reduction mammoplasty, after years of consideration. This wasn’t an easy decision for me, but I came to the conclusion that I couldn’t continue to deal with the headaches, back pain, shoulder indentations, difficulty exercising, self-consciousness, and literal weight on my chest and shoulders anymore. As anyone who has been through this can relate, I despised that people would comment on my appearance on a regular basis. I needed to control the narrative and feel comfortable in my body again, but my biggest hang-up with the whole surgery was whether or not I’d have the ability to breastfeed after the procedure. 

 

Researching Reduction Mammoplasty

With full support from my husband and my family, I started down the path of change. I researched surgeons who specialized in breast reduction, knowing that breastfeeding after surgery was the most important factor for me. I found a surgeon with whom I felt very comfortable and discussed my intentions to breastfeed down the road when we decided to have children. She knew how important it was to me, so she tailored her technique to suit my needs. 

A recent systematic review by Roni Y. Kraut, et al. determined that techniques that preserve the column of subareolar parenchyma appear to have a greater likelihood of successful breastfeeding.(1) This refers to the lactating part of the gland under the areola. There are several breast reduction surgery techniques, but it has been documented that the superior pedicle reduction mammoplasty has the best outcomes regarding breastfeeding post-surgery.(2) This was the technique that my surgeon used to give me the best chances. The tough part about this surgery was accepting that my chances for breastfeeding after breast reduction were 50/50, according to my surgeon. Granted, many people can’t breastfeed even without taking surgery into consideration, so there is no guarantee either way. I took the chance and trusted my surgeon’s expertise.

 

Our Breastfeeding Journey

First of all, I will never regret the decision I made to have my breast reduction surgery. It substantially improved my quality of life and gave me back my confidence. It was probably the single best decision I’ve made for myself regarding my physical and mental health. 

I birthed my sweet baby girl at home in April 2019, three and a half years after my surgery. To be completely honest, we had a rough start to breastfeeding. My daughter had a tongue-tie that severely restricted her ability to latch, which created so much stress – and therefore increased cortisol levels – that dropped my supply. We worked hard on our breastfeeding relationship those first few weeks. I tried everything to increase my supply: fenugreek (which can have the opposite effect for some people), brewer’s yeast, mother’s milk tea, huge amounts of water, lactation cookies, power-pumping, etc. You name it, we tried it. She had her tongue-tie released; we worked with multiple lactation consultants; we used a nipple shield for weeks that seemed to drag on and on; and eventually we (excitedly) managed to get her to latch and effectively nurse on her own. That day felt like the biggest accomplishment of my life. 

I was never able to pump much milk, which only stressed me out more. I actually went against popular opinion and dumped the pump, which ended up being the greatest change for us. Once I did that, I could focus 100% on breastfeeding on-demand (which I realize is not possible in everyone’s situation). We did use donor milk courtesy of a generous friend in the beginning, but I have continued to have low supply issues up until this point. I’ve also noticed that I produce more on one side than the other, which is a common post-surgical result. We still supplement with donor milk, but she is getting 90% of her milk from me. Breastfeeding doesn’t have to be all or nothing! My daughter is now 10 months old and still breastfeeding like a champ.

 

Recommendations

I’d be lying if I said that our breastfeeding journey was easy. It has been a struggle from day one; however, I’m so unbelievably grateful that I’ve been able to breastfeed in any capacity for my little one. Don’t let anyone else’s story deter you from having a breast reduction or from attempting to breastfeed post-surgery. Everyone’s story and experience will be different. Do your research. Find the right surgeon. Schedule an appointment with a lactation consultant (IBCLC) as soon as possible. It’s also important to mention that the human body is incredible and milk supply continues to increase with each subsequent pregnancy, so don’t give up if you’ve tried this before and didn’t have great success.(3) You need to do what’s best for you physically and mentally. 

There were a few other great resources that I used throughout this process that are worth checking out: the BFAR group on Facebook, Breastfeeding after Nipple and Breast Surgery as well as Defining Your Own Success: Breastfeeding After Breast Reduction Surgery.(4,5,6) While breastfeeding after breast reduction surgery has not been a walk in the park by any means, I still stand by my decision to have the surgery, and I will continue to breastfeed my daughter for as long as it continues to work for our family. Thank you for reading our story.

 

Shadley Centofanti, DC

Roots Chiropractic @rootschiropractic

 

References:

  1. Kraut, Roni Y, et al. “The impact of breast reduction surgery on breastfeeding: Systematic review of observational studies.” PloS one vol. 12,10 e0186591. 19 Oct. 2017, https://doi.org/10.1371/journal.pone.0186591
  2. Chiummariello, S., Cigna, E., Buccheri, E.M. et al. Breastfeeding After Reduction Mammaplasty Using Different Techniques. Aesth Plast Surg 32, 294–297 (2008). https://doi.org/10.1007/s00266-007-9023-8
  3. Ingram, J., Woolridge, M., Greenwood, R. Breastfeeding: is it worth trying with the second baby. The Lancet, Vol 358, Issue 9286, 986-987 (2001). https://doi.org/10.1016/S0140-6736(01)06126-8
  4. https://www.facebook.com/groups/458224110894529/
  5. https://www.bfar.org/index.shtml
  6. https://www.amazon.com/Defining-your-Own-Success-Breastfeeding/dp/0912500867

 

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