The ability to breastfeed after breast surgery depends on the reason for the surgery, the type of surgery, and the way it is performed. Women undergo breast surgery for many reasons. Augmentations, reductions, mastectomies, lumpectomies and biopsies are often carried out on women of childbearing age.
Some surgeries affect breastfeeding more than others, so if you are planning to have a breast surgery, discuss any future plans to have children and breastfeed with your surgeon to ensure the minimal amount of interruption to your milk ducts and the nerves around the nipple and areola. If you have already had breast surgery and wish to breastfeed, it is important to tell your current doctor about the surgery. It will be necessary to closely monitor your milk supply as well as your baby's growth.
Breast augmentation surgery is often done for cosmetic reasons. Implants are used to increase the size of the breasts or for reconstruction after a breast or part of a breast has been removed. The insertion of breast implants does not necessarily pose any risk to your ability to breastfeed in the future. As long as your breasts contain functioning breast tissue prior to the surgery and the surgery does not include an incision around the areola, you should still be able to produce an adequate milk supply.
For those who have implants for reconstruction after a mastectomy or due to underdeveloped breasts, there may not be enough functioning breast tissue in the breast to produce a sufficient milk supply. In these situations, the ability to breastfeed may be compromised even before augmentation surgery. If you plan to breastfeed, you can undergo testing to determine if you have functioning breast tissue prior to the insertion of breast implants.
A breast reduction is usually done to reduce the size of extremely large breasts. During a reduction, breast tissue and excess skin are removed to make the breast smaller. When the size of the breast is decreased, the nipple is often relocated. In order to move the nipple, the surgeon must cut around the areola. This can injure the milk ducts and affect the nerves and blood supply to the area.
Severed milk ducts can greatly decrease your milk production and damaged nerves can interfere with your let-down reflex. You can still breastfeed, but you may not be able to make enough milk for your baby even with frequent nursing or pumping, so supplementation may be necessary. If the reduction surgery can be performed while leaving the area around the nipple intact, it is more likely that breastfeeding after reduction will be successful.
A mastectomy is the removal of a breast. Most mastectomies are performed due to breast cancer. However, some women elect to have their breasts removed as a preventative measure if they are at very high risk for developing breast cancer.
After a mastectomy, depending on how much of the breast tissue was removed, the breast involved may not be able to produce much milk if any at all. Radiation therapy, which often follows a mastectomy, can cause added damage to any remaining breast tissue, reducing your chances of breastfeeding from that breast even more. However, you may still be able to breastfeed from the other breast. It is very possible for one breast to make enough milk for the baby without the need for supplementation.
A lumpectomy is the surgical removal of a breast lump through an incision made on the breast. A lumpectomy performed in the nipple area may damage the milk ducts and nerves on that breast. If the lumpectomy is followed by radiation, the ability to produce milk will be further compromised. However, if the incision is not made at or near the areola and radiation is not necessary, this minor breast surgery should not affect your ability to breastfeed.
A surgical breast biopsy is the removal of a piece of breast tissue through an incision to check for breast cancer or infection. Just as with a lumpectomy, this is a minor breast surgery and generally does not affect the ability to breastfeed unless the incision is made near the areola and nipple.
A needle biopsy is performed by inserting a needle into the breast to aspirate a breast lump, cyst or abscess. This procedure rarely has a negative affect on milk production or the ability to breastfeed.
What You Can Do if You Want to Breastfeed After Breast Surgery:
Contact the surgeon who performed your breast surgery to find out how the procedure was carried out and if it might interfere with your ability to breastfeed.
Talk to your obstetrician and the baby's pediatrician about your desire to breastfeed, and let them know that you have had breast surgery.
Tell the hospital's nursing staff and lactation consultant about your breast surgery and make sure that your baby is closely monitored during your hospital stay. After discharge, see the pediatrician often to ensure the baby's growth and development is on target.
Start breastfeeding your baby as soon as possible after delivery. Put the baby to your breast very frequently, at least every 2 hours, to help build up your milk supply. Use a breast pump after each feeding to further stimulate your breasts to make more milk.
What You Can Do if Your Milk Supply is Low:
- Breastfeed very frequently, every 2 to 3 hours around the clock, plus use a breast pump after each feeding to help stimulate milk production.
- Use a Supplemental Nursing System (SNS) if you need to supplement your baby. If you do not wish to supplement with formula, talk to your baby's doctor about using donor breast milk from a human milk bank.
- Talk to your doctor or lactation consultant about using herbs to help increase your milk supply.
- Continue to nurse for as long as you would like to regardless of the amount of milk you are producing. Even a small amount of breast milk will provide your baby with many health benefits, and the emotional bond and security of the breastfeeding relationship can be very rewarding.
American Academy of Pediatrics. New Mother’s Guide To Breastfeeding. Bantam Books. New York. 2011.
Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Sixth Edition. Mosby. Philadelphia. 2005.
Newman, Jack, MD, Pitman, Theresa. The Ultimate Breastfeeding Book of Answers. Three Rivers Press. New York. 2006.