By Erin Margaret Joyce
When I was 15, the subject of breast reduction was brought up by my doctor due to significant back pain and a curving spine. At the age of 17, I finally went through with it and had my breasts reduced. The reduction itself was probably one of the best things that could have been done for my back pain and overall body confidence. However, not much thought was given to what the actual purpose of the breast is and how the surgery would affect my ability to breastfeed when/if I had children in the future.
From the beginning of my pregnancy, the question of “can I breastfeed?” seemed to be one of my biggest questions. I wished it was a cut-and-dried answer… however, it wasn’t. Much of my adult life this question would cross my mind. Then the day came when it went from some kind of back-of-my-mind thought to something that would have to be addressed.
After I found out I was pregnant and cleared the 25-week goalpost of pregnancy, I started looking into resources about breastfeeding after a reduction. Due to a higher risk pregnancy, I spent a lot of time on bed rest searching the web for answers to my questions. My resources seemed limited to a few blogs and mother/baby forums. Ultimately what it came down to was finding out the nature of how my reduction and reconstruction was performed. The biggest question being the milk ducts, and if they were cut during the surgery.
Hunting down the surgeon from a decade prior was a task. I began the quest to locate the medical records—more specifically, having someone review my surgeon’s notes for me. Ultimately, I got the answer that indeed my milk ducts had been cut. Because of the severing of the nerves, breastfeeding was really contingent on if the nerves healed. I had little to no feeling in my breasts, which the surgeon’s nurse stated was a good indication that there was nerve damage and I would most likely not be able to breastfeed.
I cried about this quite a bit; I felt that my body in general was fighting for this pregnancy as hard as it could. There was guilt and grief each time someone asked me if I planned to breastfeed. Due to hyperemesis I had a home care nurse who visited a couple times a week. She strongly encouraged me not to close the door on breastfeeding. Eventually I came to terms with the idea that I would try to breastfeed, but have very open expectations of what that experience will be.
The barrage of pre-birth planning was a bit daunting (as any first-time parent would say). As much as I optimistically sat on the egg of positivity that I would breastfeed, the answer was much like the theory of Schrödinger’s cat: The answer wouldn’t be known until the baby arrived.
My daughter was born after 96 hours of labor and a couple of kidney stones. Because of my orthopedic structure, my daughter was unable to make it through my labyrinth-y pelvis and was delivered via emergency C-section.
After my daughter was born, I was being attended to via a more “old fashioned” nurse, who offered to request medication to dry up my milk supply if it came in, as in her experience she did not see many mothers breastfeed after breast reductions. I was adamant that I still wanted to pump and consult with a lactation specialist. She wheeled the pump in and pretty much left it to me to “figure it out.” I tried pumping and felt horribly discouraged as nothing happened.
A couple of hours later, the lactation consultant came in and gave me a course in breast pumping 101. She too didn’t know if I would produce any milk, but supported my efforts in trying. She sat with me as my daughter lay across my body and I pumped one breast at a time. Eventually, I started to produce some colostrum; it wasn’t much, literally just a couple of drops. But it was a sign things were being stimulated.
My pumping efforts paid off and, though I had no feeling in my breasts, I watched miraculously as they nearly doubled in size and my bi-hourly pumps produced about 1/4 an ounce at a time.
The next day, I worked with the lactation consultant on actually feeding via the breast. Although I had been skin to skin with my daughter, I really wanted the bond that came with breastfeeding. However, my nipples, having been reconstructed, did not respond to stimulation like most. I was able to get her to latch a few times, and use of a nipple shield proved to allow this experience to happen best.
Postpartum, I spent a lot of time pumping and didn’t count on my milk supply as a sole form of nourishment or really anything other than a supplement for my daughter. At most I made 4 ounces a day, but these 4 ounces exceeded my expectations and I knew they were providing vital nutrients to my daughter, even in their small quantities.
At 5 weeks old, my daughter developed a septic kidney infection and we spent 11 days in the hospital. My body’s physical reaction to the stress was to cease releasing milk during my pump sessions. Though I had no feeling in my breasts, they were heavy and dense and I knew there was milk so I still pumped, but nothing came. A lactation consultant visited me in the PICU and she rocked my world in the best way possible. Her visit with me offered nothing but support for my efforts and a supplemental nursing system. Paired with a nipple shield, this combo was what made continued breastfeeding possible.
I used this combination as much as possible, and still pumped regularly for as long as I was physically able to. Due to both health reasons that required medication that I had to pump and dump and a bird chewing through the power adapter of my breast pump, after 5 months I ended my efforts of breastfeeding. However, I felt quite satisfied with the effort put forth.
[Tweet “Each person’s body is their own, as is their breasts, and experience in #bfing.—Erin Joyce”]As I come across more people who are post-breast reduction, I find that more and more people are making the effort to breastfeed. Also, with advancements in surgical procedures, consideration for milk ducts and nipples is becoming more common practice in the field of plastic surgery. Ultimately, breastfeeding post-reduction is a case-by-case situation. A person can only prepare so much for something that does not have a finite answer. Each person’s body is their own, as is their breasts, and experience in breastfeeding.
If you are facing the unknown of post-breast-reduction breastfeeding, please know that any effort you put forth is pretty freaking awesome. Do not be afraid to ask for help, or use assistive devices in your experience. Carry on, my lactating lovelies!
Erin lives in the suburbs of Minneapolis with her husband, mischievous 5-year old daughter, and array of critters. In her not-so-spare time, she is sex positive, death positive, and an amateur cat photography enthusiast. She finds writing in third person a bit uncanny.
For more information about breastfeeding after breast reduction or breast/nipple surgeries and for dealing with low milk supply, visit www.bfar.org and www.lowmilksupply.org.
