Breastfeeding after breast surgery.

This is a topic I’ve been meaning to write about for a while. I’ve been pushed to do it because of yet another sad situation of low milk supply and weight gain issues at clinic this past week.

Basically, I want you all to know that if you have had ANY breast surgery there is the POTENTIAL that it could affect your ability to breastfeed and/or provide enough milk for your baby.

I don’t say this to cause unnecessary worry. I’ve just had too many mums and babies come to see me recently, where mum has had breast surgery and she’s been told during pregnancy by (no doubt well-meaning) health care providers that her breastfeeding will be “just fine” or that she will just have to “wait and see”.

This advice is just not good enough. It ignores the evidence and women deserve better.

Even when breast surgery is done using techniques that should ensure your breastfeeding journey is protected, each of our bodies is individual. Without an assessment by a person skilled in all aspects of lactation and breastfeeding (e.g. an IBCLC like me) you cannot be fully informed about your chances of meeting your own breastfeeding goals.

So, if you have had breast surgery and intend to breastfeed, please see an IBCLC BEFORE your baby arrives.

If you have an appointment with me while you are pregnant, we can explore your individual situation and properly assess whether your breast surgery could affect your breastfeeding journey.

Together we can discuss:

1. Incisions during surgery - the location and type of incisions may affect:

a. the glandular (milk-making) tissue in your breasts

b. the ductal system which allows the milk to flow from the glandular tissue and out the nipple

and/or

c. the nerve supply to your breasts. A good nerve supply to your breasts is essential so that when your baby is suckling a strong hormonal signal is sent to your breasts to release the milk (this is known as the Let-down or Milk Ejection Reflex).

2. Your nipple sensation – were the nerves leading from your nipples affected by your breast surgery and do you have good sensation in them? A good nerve supply is needed:

a. to trigger a strong Milk Ejection Reflex (see above)

b. because if we have reduced sensation in our nipples it can be much more difficult to tell whether our baby is latching well, because we may not feel any damage they are causing.

3. Breast reduction surgery - how much glandular (milk-making) tissue was removed and how much might remain. A reasonable amount of glandular tissue is needed so that you will produce enough breast milk.

4. Breast implants (augmentation) surgery - what your breasts looked like visually before the surgery and is there any risk that you might have had breast hypoplasia (where your breasts were under-developed), which has its own risks for breast milk production. The placement of the implants can also affect breast milk production, with those placed under the muscle much less likely to cause damage to milk-making structures.

   
   

5. How your breasts have changed during pregnancy - during pregnancy breasts should grow by at least a cup size and there should be some other visual changes in the colour and size of your areola.

   
   

6. How breastfeeding works - how to make sure breastfeeding gets off to the best possible start, how to tell if your baby is getting enough milk, what normal breastfeeding looks like, etc. We can even make a Plan B for if things don’t seem to be working well initially.

   
   

7. Any other questions or concerns that you have about feeding your baby.

Also if you get to know me while pregnant, then you can keep in touch with me during the early days and weeks of breastfeeding, and we can monitor your progress and make sure any issues are sorted out before they become major concerns.

I live in the real world. I know that many women who have had breast surgery DO successfully breastfeed. This post is just to let everyone know that it’s better to be well informed BEFORE your baby arrives, so that then you know all your options.

Get in touch if you would like to know more. Shona x