Janet: My understanding of breastfeeding after reduction surgery is that
it can vary depending on the type of surgery. What you described with the
nipples being completely severed carries an extremely low chance of
lactating successfully, although the mother could be encouraged to try
with close supervision and with anticipatory guidance that the likelihood
of producing an adequate milk supply to fully feed the infant is low (
the mother, like some very committed adoptive mothers who wish to nurture
the baby at the breast even if they need to supplement with SNS, may want
to try with that understanding). The reason that her chances are so small
is not only that the ducts were severed, but also the nerve supply (which
is needed for the feedback to the pituitary for release of oxytocin). A
recent reference you might look at is by Marshall DR, Callan PP and
Nicholson W. Breastfeeding after reduction mammoplasty. Br J Plast Surg
1994;47:167-9. They describe the breastfeeding histories of 30 women with
previous reductions, and the group with the most success were those whose
surgeons had maintained some nipple attachment. But even among those with
little or no nipple attachment during surgery, 3 out of 4 had
"reasonable" milk production(able to provide at least half of infant
intake), one had "poor" production (little or no milk). None of this
group had "good" production (no need for early introduction of
complementary feeds). Hope this helps. Alicia. [log in to unmask]