Hi Janet
There are two main considerations after breast reduction with respect to
breastfeeding. Firstly, there has to be enough breast tissue left that can
produce milk. As the capacity of the breast to produce milk is enormous,
I would guess that a vast amount of glandular tissue would have to be
removed to render the mum unable to lactate. Probably more important is
whether the surgery affected the nipple. some surgeons completely remove
the nipple and then 'replant' it in the new spot (!). IN this case, all ducts
and nerves are cut, and establishing breastfeeding can be very difficult
unless ducts have managed to rejoin. As the nerves have been cut, nipple
stimulation can be drastically reduced, affecting MER and hormonal responses.
More frequently nowadays is the 'pedicle' type of surgery, where the
nipple is left attached to the areola and underlying breast tissue. In these
cases the majority of women can breastfeed, although many have problems
with supply and may need to supplement. Sometimes the nipple is less pliable
after surgery, or can appear flattened or inverted. Engorgement can also
be a problem in the early postpartum period as some parts of the breast
may not drain properly due to ducts being damaged or severed. I have some
references if they are of use to you.
Hope this helps
Fiona Coombes
NMAA Breastfeeding Counsellor
Family Physician  IBCLC
Perth, Western Australia