If you have had (or are thinking of getting) breast reduction surgery, you may wonder how the surgery may affect breastfeeding.

The aim of breast reduction surgery is to decrease breast volume. As such, a certain amount of milk ducts and glandular tissue may be damaged or removed. The more this occurs, the greater the potential impact on your milk-making ability.

Some mothers after breast reduction surgery may produce little, if any, milk, while others produce a full supply.

However, all mothers can breastfeed successfully – the key is to defining your own success (read on to find out more).

Breastfeeding After Breast Reduction Surgery

Here are 5 key questions about breastfeeding and breast reduction surgery answered:

#1: How Might Different Breast Reduction Surgery Techniques Impact Breastfeeding?

Breast reduction surgery techniques that have the least impact on a woman’s milk making ability are those in which all remaining functioning breast tissue is left attached to her nipple. In other words, the areolae and nipples are not fully severed (although they may have moved).

Also, if an incision is made close to the areola, there is a greater risk of damaging nerves that are important for the letdown reflex (milk ejection reflex).

The letdown reflex is important, to allow the milk stored in the breast to be made available to the baby. Hence, if your letdown reflex is affected (or doesn’t occur), then less milk gets removed from your breasts — and this can affect your supply.

#2: Can Breast Reduction Surgery Affect Milk Supply?

Breast reduction surgery can affect supply. The degree to which the surgery affected glandular tissue, milk ducts and/or the nerves that affect the let-down reflex are factors that can influence a mother’s milk making ability.

Fortunately, however, ducts and nerves can regenerate to a certain degree. Nerves can (very slowly) regenerate and so if they were damaged in the initial surgery, years later they may be able to function (at least somewhat) again.

Also, over time, milk ducts can reconnect and new pathways can be made. Pregnancy and breastfeeding are the times when most of this duct reconnecting occurs. Therefore, even if a mother struggles with her supply with her previous baby, she may have more milk with subsequent babies.

#3: How Can A Surgeon Maximise Your Milk Making Ability?

If you’re thinking about getting breast reduction surgery, you could request that your nipple remains attached to the remaining breast tissue, and for the incision to be made somewhere other than near your areola, in order to maximise your milk making ability.

#4: How Can I Maximise My Milk Supply After Breast Reduction Surgery?

Since your milk supply is largely established in the early weeks, getting breastfeeding off to the best start possible can help maximise your supply.

Here are some ways to help to get breastfeeding off to the best start possible:

Consider natural pain relief options for labour
Skin-to-skin contact with your baby straight after birth, followed by rooming in with your baby
Feeding your baby according to need
Optimal positioning and attachment
Avoiding supplementation unless medically indicated

Speaking with an Australian Breastfeeding Association counsellor (La Leche League in the US) or seeing a lactation consultant can help with individualised support and information to help maximise your supply too.

Despite getting breastfeeding off to the best start possible, if you still struggle to make enough milk, you could speak with your doctor about use of a galactagogue (a substance that increases milk supply).

For more information about medications and herbs to help increase milk supply, see The Breastfeeding Mother’s Guide to Making More Milk by Diana West and Lisa Marasco.

#5: What If Breastfeeding Doesn’t Work Out How I Wanted It To?

It is important to remember that ‘successful’ breastfeeding means different things for different mothers.

Breastfeeding is so much more than just about the milk. It is a relationship with a baby. So, even if you find you are unable to make a full supply, if breastfeeding your baby makes you feel happy, then no matter how much (or little) milk you make, that is ‘successful’ breastfeeding.

Some mothers who don’t make a full supply, find using a breastfeeding supplementer (e.g. supplemental nursing system) helpful. This is a device that allows a baby to receive supplemental milk while feeding from the breast.

For more information about see Defining Your Own Success: Breastfeeding After Breast Reduction Surgery by Diana West.