Can You Breastfeed After a Breast Reduction?

I'm about to become a mother in 6 weeks, and a bit more than a year ago I had a breast reduction. Will this interfere with breastfeeding? I’m a bit scared I won’t be able to produce enough milk for my baby girl. I need help!

hope1990

F, 36, New York

Breast reduction surgery can injure the milk ducts and affect a woman's ability to nurse her baby. Previous lactation experience, having a support system, and the length of time after the surgery are factors that may affect a woman's ability to produce milk following breast reduction. If your surgeon carefully sought to preserve your major nerves, you may be able to successfully breastfeed from one or both breasts. BFAR (Breastfeeding After Reduction) is a support group that you may find help helpful.

The surgical reduction of a woman's breast size may cause permanent damage to the nerves and to the milk-producing glands and ducts that are needed to successfully breastfeed your baby. But, don't get discouraged. There is a good chance that you can breastfeed after having a breast reduction. 

If the nipple and the areola remain attached to the breast's tissue, it is quite possible that you will successfully produce enough milk to nurse your baby. If the nipple was surgically removed and then repositioned on a reconstructed breast, damage to the milk ducts, the nerves and to the breast tissue may have occurred. This damage could result in a hindered flow of breastmilk and cause diminished feeling and sensation in the nipples. 

Nerves are important when breastfeeding because they trigger the release of two hormones, prolactin and oxytocin. These two hormones are key to the production of breastmilk and its letdown into the milk ducts. After a period of time, breast tissue and nerve sensation is more likely to be restored by the areola and the nipple, and the production of milk is more likely. 

Steps for Breastfeeding After Breast Reduction:

You will not know exactly how your breasts and nipples have been affected by the surgery until the baby is born and you begin to experiment with nursing. The baby's weight must be closely monitored to ensure that she is getting enough milk and nutrients to grow and develop. A breastfeeding expert can be requested in most hospitals that can help you to recognize when you are producing enough milk and if the baby is latching on properly to the nipple. 

Three days after the birth of the baby, you can begin to use a manual, electric breast pump or a dual electric breast pump for five extra minutes following each nursing session with your baby. This will increase the amount of milk that your body produces, and it will stimulate the letdown process. 

Supplementation with formula or banked, natural breastmilk may be used if you are not producing enough milk. A supplemental nursing system may also be used to feed the baby and to stimulate additional milk production. Stay positive and be patient. Ask for the help of a breastfeeding expert and get the support of other mothers. 

The answer to your question is: it depends.  First off, if it is your first child it is possible that you are not able to breast feed even if you did not have the surgery.  Not all women produce enough lactate milk to breast feed. Secondly, it depends on what technique is used when performing the breast reduction:  

1) The free nipple, or areolar graft, technique requires that the areola and nipple are removed.  Once removed it is replaced as a skin graft, in essence severing the blood vessel, nerve, and milk duct connections.  If the breast reduction is done using this technique you will NOT be able to breast feed because you will no longer have breast function.

2) During the Pedicle technique the areola and nipple remain intact while excess breast tissue is extracted.  Since your glands do not become severed you keep complete breast function and sensation of the nipples and are able to breast feed after the reduction.