Erin asks: do you have any concerns or experience with breastfeeding
mothers that have silicone implants, and what is your reaction to the Levine
and Ilowite study (done on 11 children of mothers with silicone implants and
17 children not exposed to silicone implants)?

My experience with breast implants has been that they DO cause difficulty
during the first few days - I've seen mothers suffer through extreme
"ngorgement" where their tissue is terribly stretched and nipples become
flattened and difficult to grasp.  

Some mothers continue, others quit due to the discomfort and/or fear of
"damaging" their breasts (which they have invested a great deal of $$
on...). 

However, there IS a concern that needs to be addressed, and that is why the
implants were needed in the first place.  In some cases, it was cosmetic,
but in others there was clearly not much glandular tissue in the first place
- implants can disguise this issue and a mother may actually be incapable of
producing a full milk supply.  

Any woman who has had breast or chest surgery, where there have been cuts
into the glandular tissue (whether heart surgery during her infancy or
breast surgery as an adult) needs to be followed closely - not only at
first, but maintaining a watch about the ability to produce adequate milk
for the growing baby.  One mom I saw was fine for about 3 months - then "hit
the wall" and was unable to increase milk production.  She continued to
breastfeed, but had to supplement until her baby started solids - then she
"weaned" from formula and went back to exclusive breastfeeding combined with
solids.

Some incisions might also have affected the nipple's innervation - I've had
moms who had this happen to only ONE breast, even though both had surgery -
they can exclusively breastfed on the unaffected side.  Nature CAN
circumvent a lot that "man" (or "woman") does!

A great resource is the Breastfeeding after a reduction website -
http://www.bfar.org/ - even though these are augmentations, the philosophy
of "Defining your own success" is excellent for any woman with these issues.

Jeanette Panchula, BSW, RN, PHN, IBCLC
California

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