I have had several clients over the years who had had breast reduction
surgery and who wanted to feed their babies.  One of them was remarkable
because in her surgery (when she was 16) her areola and nipple were removed
and moved to a higher place on her newly-shaped breasts.

When she called me (at age 32) during her pregnancy I suggested that we
assume that she would be able to successfully breastfeed and if that were
not the case we would deal with it as it came.  Others told her that even
if she produced milk it would not be able to come out.

SHe did produce milk, and a lot of it, and it came from the nipples the
same as anyone's milk.  SHe continued to have doubt because "everyone" kept
telling her that she did not have an adequate supply.  She finally stopped
listening to them and went on to feed her baby for 1 1/2 years.

I have had other clients who had limited milk supplies and some who had
nothing after the colostrum.  These latter ones were just glad that their
babies got the colostrum.

I hold the theory that the amount of time from surgery to the birth has a
lot to do with the re-canalized  ductal system.  Every menstrual period
lays down more duct work.

However, I recently worked with a mother whose surgery was 10 years before
and she produced only drops.  I was puzzled until I thought to ask her if
she used birth control pills during those 10 years and she had.  So the
normal premenstrual ductal growth may have been interfered with. Having
been "pregnant" for those 10 years did not allow the normal hormonal
stimulation of the breasts.

It may be rare for a 30+year old woman to not have been on some kind of
hormonal birth control since her surgery.  The first woman whom I wrote
about was one who followed a natural diet and avoided drugs.

In another vein, I have a client whose baby is about 14 months old and she
has had a yo-yo-ing milk supply for several months.  She has used herbals
and domperidone with success but recently tried foot reflexology and her
milk supply is stable now.  Another one a few years ago found that
acupuncture was very helpful.

There may be more than just the structural nature of the surgery that
interferes with a woman's capacity to lactate.  Hormonal, emotional:
regret, guilt, etc, nutritional, or other physical aspects.

Patricia Gima, IBCLC
Milwaukee, Wisconsin
www.walc.net
Mailto:[log in to unmask]

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