Breast-feeding following procedures such as breast augmentation or reduction is usually possible, depending on the type of surgery undertaken.1–3 For example, breast augmentation is now usually performed with incisions close to the chest wall, which reduces the occurrence of breast-tissue damage. Silicone and saline breast implants are considered to be compatible with breast feeding. Silicone and saline breast implants are considered to be compatible with breast-feeding. Silicone injections are not undertaken, and there should be no destruction of breast tissue or interruption of ducts, nerves or blood supply to the gland or nipple.

Surgical techniques have improved considerably over time3 and women are counselled about the possible detrimental effects of surgery on breast-feeding before they are operated on, but the implications of surgery on the woman’s ability to breast-feed may only become apparent once she is planning a family, many years later.3,4

Whereas breast augmentation should result in minimal interruption of the lactation process, breast reduction can cause permanent damage to milk ducts, nerves and blood supply to the breast and nipple.1

Breast-feeding should be encouraged, with realistic expectations. Women who wish to breast-feed after surgery should be counselled so that they are aware of their individual risks and common problems. For example, if the milk ducts were cut or damaged during surgery, the mother may experience engorged areas that do not soften with feeding. However, this is usually a short-term problem that subsides as the milk supply settles. But incision areas and internal scarring may cause breast discomfort and increase the risk of lactation insufficiency.

The main concern is whether the baby is receiving adequate nutrition. Even if breast milk supply is insufficient, offering the breast before supplemental feeding can give the baby important antibodies and immunities, as well as continuing to form a strong bond between mother and baby. Mothers with a history of breast surgery should be offered careful assessment during the early postnatal period. If exclusive breast-milk feeding is not possible, several supplemental nursing systems are available, where breast-feeding can continue at the same time as formula is fed via a tube. See: Non-nutritive sucking 

References   

  1. Riordan, J,  Auerbach K. Breastfeeding and Human Lactation:  Massachusetts: Jones and Bartlett, 1999.
  2. Shaikh U et al. Breast augmentation and breastfeeding: knowledge and practices of surgeons in Las Vegas, Nevada. J Plast Reconstr Aesthet Surg 2006; 59: 434–436.
  3. Zimpelmann A, Kaufmann M. Breastfeeding nursing after breast surgery Zentralbl Gynakol 2002; 124: 525–528 (in German).
  4. Engström BL, Fridlund B. Women's views of counselling received in connection with breast-feeding after reduction mammoplasty. J Adv Nurs 2000; 32: 1143–1151.

Resource

Breast feeding after breast and nipple surgery (US website) http://www.bfar.org/. Accessed 12 November 2009.

From: Journal of Family Health Care Bulletin. Directory of Breast-Feeding Advice. December 2009. Published with JFHC 2009; 19(6). http://www.jfhc.co.uk/images/stories/breastfeeding.pdf