Breastfeeding isn’t a given for every new mother. Although the majority of Canadian women breastfeed their babies — 89 per cent in 2011-2012, according to Statistics Canada — of the 11 per cent who don’t, nearly a quarter cited a medical condition as preventing them from breastfeeding.
There’s no way of knowing how many of those medical conditions are linked to surgical procedures that rendered breastfeeding difficult or impossible, but there are some surgeries or modifications that could pose problems.
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“Any kind of breast surgery can have an implication on breastfeeding, but it’s not impossible for women who have undergone surgery or modifications to breastfeed,” Kirsten Goa, chair of La Leche League Canada, says to Global News.
Whether it’s breast augmentation, reduction, nipple inversion surgery, a lumpectomy or a nipple piercing, here’s what you need to know about breastfeeding after surgery.
Breast augmentation
“In the vast majority of cases, breast augmentation does not interfere with breastfeeding,” Dr. Frank Lista, a plastic surgeon and director of The Plastic Surgery Clinic in Toronto, said to Global News. “Implants are placed above or behind the pectoralis major, never in the breast itself. The connection between the gland and the nipple remains intact so a woman can breastfeed.”
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Not only do the implants not interfere with the milk ducts, they also don’t compromise the quality of milk.
Breast reduction
In fact, it’s the opposite scenario — breast reduction surgery — that could pose problems. Because there’s a loss of breast tissue just by nature of the surgery, some of the milk ducts could be removed. However, that doesn’t mean that a woman won’t be able to breastfeed.
“With the most common type of breast reduction surgery, the nipple remains attached to the gland by means of a flap, which means the patient can still breastfeed. The only problem is that she may not produce enough milk for the baby to live on it alone,” Lista says. In his experience, however, most of his patients who had breast reduction surgery at a young age have successfully managed to breastfeed.
What’s more, a woman may only have trouble producing enough milk for her first child. But her body could correct itself for any subsequent births.
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“What’s neat about this is that because the body grows more milk ducts in pregnancy, it will grow more with a second or third pregnancy, so a woman could possibly breastfeed those babies exclusively,” Goa said.
However, in rare instances, surgeons may need to use the Free Nipple Graft technique in reduction surgery. With this technique, the nipple and areola are removed and then reattached, and the flap is cut thus making breastfeeding impossible.
Inverted nipple surgery
In the case of women who have inverted nipples, their ducts are too short and pull the nipple inward. Breastfeeding is more troublesome for these women, but not impossible — unless they undergo surgery to correct the appearance.
“Sometimes when these women breastfeed, the nipple comes out and it can either stay out or go back in,” Lista says. “The surgery will correct the appearance of the nipple, but it will cut the ducts, so these patients can’t breastfeed.”
He says most women want this correction for cosmetic reasons, but he advises them to hold off on the surgery if they haven’t had children or tried breastfeeding.
Lumpectomy
Much like breast reduction, this procedure is entirely dependent on which part of the breast is removed.
“If the lump was near or under the nipple, a patient may be rendered unable to breastfeed. But if it was remote and the nipple remains attached to the gland, it’s not a problem,” Lista says.
Nipple piercing
This may seem like an innocuous modification, but if done incorrectly, it could seriously compromise a woman’s ability to breastfeed.
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“The risk is that the piercing can divide some of the ducts, especially if it’s very big. The best way to prevent this is to use a small piercing and to do it as deep as possible because if it’s closer to the surface of the nipple where the ducts are more compact, it could sever them,” Lista says.
Goa says that she hasn’t encountered many issues with patients who have nipple piercings, but she does caution one thing: “sometimes, the milk will leak out of the hole left in the nipple.”
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