Written by Ashley Treadwell, IBCLC
Many women wonder if they will have a full supply after having a breast reduction. While the basic answer to this question is “we don’t know yet” - there are many factors, as well as things she can actively do, that can affect her ability to breastfeed successfully. In this article, we will discuss what those activities are and how a mom can maximize her supply when breastfeeding after a breast reduction. We will also look at what long-term supplementation can look like, if it is necessary.
It is important to remind you that breastfeeding does not have to be an “all or nothing” endeavor! We need to re-define what “success” means when it comes to breastfeeding after a breast reduction. Anytime a woman has a physiological factor that can affect milk supply, we always want her to understand that ANY amount of breastmilk is amazing. Whether she is able to provide 10% or 100% of what her baby needs, she is doing a fantastic job.
What Factors Will Affect My Ability to Breastfeed Exclusively?
An initial factor is how the surgery was performed. Fortunately, surgeons are currently performing breast reduction procedures in a manner that protects as much of the lactation function as possible - increasing a woman’s chance for breastfeeding later in life. If a large amount of breast tissue has been removed, or the ducts that deliver the milk to the nipple openings are severed, breastfeeding may be negatively affected. There are many different types of procedures and it isn’t always possible to tell which type was performed by simply noting the shape and placement of a woman’s scars. If you have had a breast reduction surgery and don’t know the specific type that was performed, the best way to gather this information is to contact the surgeon who performed the procedure. The most popular surgery performed in the United States is one that is also known to have the best implications for breastfeeding later in life. In this procedure, the areola isn’t completely removed and, therefore, connection between the nipple and breast tissue/ducts is partially protected. If the procedure involves removing the nipple completely and then surgically reattaching it, your chances of exclusively breastfeeding can be decreased.
Another factor that will affect your milk production is when the procedure was performed. The longer the time between the birth of your baby and the procedure, the better your chances will be to develop a full milk supply. Also, your milk supply is likely to increase with each subsequent birth - so if you are not able to exclusively breastfeed a first baby, there is still a good possibility you will be able to with a second or third child! These factors are each important because with both time and breast stimulation, breast tissue can actually re-grow and re-connect. This can be very encouraging for first-time moms to hear - that even if they are not able to provide their first baby with 100% of their breastmilk needs, all the hard work they are putting in is likely to pave the way for a larger milk supply with later children.
What Can I do to Maximize my Milk Supply - Before and After my Baby Arrives?
Something ALL moms can do to best prepare to breastfeed a baby (those who have had reduction procedures and those who haven’t!) is to educate themselves prior to the baby’s arrival. Take a breastfeeding class taught by an International Board Certified Lactation Consultant (IBCLC) and find out which resources are available in your area. Free support groups are a wonderful place to get help and support, as well as connect with other moms who are currently breastfeeding. We encourage women to attend our breastfeeding support groups while still pregnant - it’s a great way to familiarize yourself with breastfeeding women. A breastfeeding class will teach you what normal breastfeeding looks like in the first few weeks - this knowledge can help to reduce a lot of stress and anxiety.
Find an IBCLC who is knowledgeable about helping women breastfeeding after a breast reduction. Most offer prenatal consults that will specifically address what you can do to maximize your milk production, including different herbs available to help with supply. And even if you don’t meet with one prior to birthing your baby, she can be there as soon as baby arrives to help, if needed.
Once your baby arrives, the very best thing you can do is to breastfeed that baby constantly! The more stimulation your breasts receive in the early days, the better your milk supply will be. Babies feed frequently in the early days - knowing the signs that baby is getting enough are important. We have great information in a blog post about how to know baby is getting enough in the first week - I’ve Had My Baby, Now What? Breastfeeding During the First Week.
Some signs that baby isn’t getting enough are: baby not gaining weight after the 5th day of life, baby not having the recommended number of pee and poop diapers per day, or baby is well under birth-weight by 2 weeks of age. If you are experiencing any of these issues, it is important to seek out the help of an IBCLC.
If Long-Term Supplementation is Necessary - What are My Options?
It may be the case that some amount of supplementation is necessary for a woman breastfeeding after a reduction, especially for her first baby. If this is true - there are many options available. Whether mom has little to no supply, or close to a full supply, the best way to supplement a baby to establish a wonderful breastfeeding relationship is to feed the baby the additional milk at the breast. There are supplemental nursing systems (SNS) available that are made for this specific situation - an IBCLC can help a mom learn how to use this. If mom doesn’t want to supplement baby this way, but does want baby to have time at the breast, she can still feed the baby at the breast and then follow up with another feeding method - like a slow-flow bottle. If having baby at breast is important to mom, we do recommend that a bottle isn’t introduced until baby is latching well at the breast - some time after week 3. Prior to then, mom can supplement using a SNS, and then move to some combination of that and a bottle after the baby is 3-4 weeks of age. Supplementation can either be with mom's pumped milk, donor milk from another breastfeeding mother, or commercial formula. Here is our YouTube video showing one way a mom can supplement her baby at the breast: Supplementation: SNS at Breast
What Resources are Out There to Help Women Who Want to Breastfeed After a Breast Reduction?
Having support and help both before and after the birth of your baby is crucial and can have a lasting effect on your breastfeeding experience. We encourage all moms, whether they’ve had breast surgery or not, to look for breastfeeding support in their communities. Women who are breastfeeding after a breast surgery may need additional support and information specific to their unique situation. One of our favorite places for support is the website Breastfeeding After Breast and Nipple Procedures. Here you can find links to health care providers in your area who specialize in helping women post breast surgery, as well as a community of women who are in your same situation. Robin also interviewed Diana West for The Boob Group podcast episode: Breastfeeding After Breast Reduction Surgery.