Breast Surgery and Nursing

Whether you have a biopsy or lumpectomy, breast reduction or augmentation, there is the likelihood of complications in breastfeeding your child. The statistics differ for each surgery.

Lumpectomy and Biopsy
These surgeries fortunately have the least probability of breastfeeding complications. A lumpectomy is the removal of a lump with minimal removal of surrounding tissue, while a biopsy is removal of tissue for examination. The main risk with these surgeries occurs when nerve tissues or milk ducts have been severed.

Breast Reduction and Augmentation
The possibility of lactation insufficiency jumps to 50% if you have had an augmentation. A study run by the National Center for Policy Research found that breast surgery is three times more likely to cause problems with insufficient milk supply, while a surgery through nipple incision is five times more likely to cause complications! The numbers reach a top estimate that 65% of women with breast surgery will have lactation difficulties.

Although experts are not sure of the reasons why breast augmentations cause lactation complications, there are some guesses. The answer lies in the surgical incisions and the implant itself. Periareolar incisions cut nerves that are important to the let-down reflex. Implants put pressure on breast tissue and may possibly damage that tissue.

There are many serious complications that can occur. A woman with previous breast surgery can get mastitis (infection of the breast tissues), galactocele formation (a milk filled tumor in your breast) and even galactorrhea (lactation that occurs without the occurrence of pregnancy or childbirth).

If you are considering having an augmentation, reduction or even a lift, you may want to wait until you are done breastfeeding. Also, explore all your surgery options; depending on the clinic and location you attend, you may be able to save a substantial amount of money.

Breastfeeding Complications: How Will I Know?
If you have milk supply concerns, the following points will help you ascertain your level of lactation sufficiency:

• Talk to the surgeon who conducted the operation: ask him about the type of surgery and what the odds are of nerve damage or severance of the milk ducts.
• A good indication of tissue severance is loss of feeling in the nipple or breast area.
• Find out whether your newborn is getting enough milk (read section below).
• Keep trying! Studies have found that many women with breast surgeries simply do not attempt to breastfeed due to a fear of lactation insufficiency and complications.

Is Baby is Getting Enough Milk?
Here are some signals that your baby is healthy and all the milk he or she needs:

• Your baby should be nursing approximately every two hours: this equals about 8-12 feedings a day.
• After your newborn's third day of life, she should have two to five bowel movements a day. This means six to eight soiled, wet cloth diapers or the equivalent of five to six disposable diapers.
• After the fourth day of life, a newborn will put on about one ounce a day, equaling four to seven ounces a week.

What can I do if my Milk Supply is Insufficient?
You can try a nurse supplementer with the breast. This is a device which allows you to mix formula milk with breast milk. You just slip a tube in your baby's mouth while it suckles at your breast. This way, your baby will still get some of those essential nutrients that your breast milk supplies.

Questions about breast surgery and breastfeeding? Talk to other women about it in the forum