I have seen several women who have had reduction surgery and fully
breastfed.  This has happened more lately than it used to when I first
started seeing moms (in 1988).  I think that in the earlier years of my
practice I saw more moms who (years earlier, usually) had surgery that was
less careful to protect breast function.  I still occasionally see someone
with a free nipple graft, but more of the surgeons try to preserve the
central pedicle now, and sculpt around the nipple/areolar complex.
Consequently, I've seen some reasonably normal outcomes in the last number
of years.  You still have to watch these moms, because sometimes other
issues (like obesity, perhaps with connected issues such as insulin
resistence, or hormonal anomalies secondary to PCOS, etc) may also be
involved.  So the surgery per se (while adding tremendously to risk factors
for insufficient lactation) may not be the only issue to assess.  The amount
of time since the surgery may also impact.  I've found some women who report
poor nipple sensation for up to and over a year after the surgery, with
gradual return of feeling over time.  If the nerves that supply sensation to
the nipple are injured, the neural pathway to the brain is "dampened" and
letdown is negatively affected.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html