David, I offer prenatal consultations to women who had breast reductions or lifts. I ask them to send me a copy of the surgical report in advance, so we can discuss the possible implications of their procedure. I ask about/examine for: nipple sensation (poor sensation is a sign of greater nerve injury) and shape (sometimes in the quest for best esthetic outcome, the nipples are positioned so that they are difficult for the baby to access), amount of tissue removed (the more tissue removed, the more terminal end buds are removed, which are the future lactocytes), time since the surgery (there is some regeneration), type of surgery (inferior pedicle usually has better outcome in regard to supply than free nipple graft). I educate women on positioning and latch, how to know baby is getting enough milk, danger signs (stellate nipple cracks especially, but any nipple pain and damage), and what their options are if milk supply is reduced- pumping, seeing a breastfeeding medicine specialist for galactogogues, using supplemental feeding devices at breast. I find that women who have significant supplies breastfeed about as long on average as mothers wo do not have reductions; whereas those with very low supplies drop out pretty quickly. I'd like to see research on breast reduction vs breastfeeding duration control for supply issues. Many moms tend to feel it is not "worth it" if they are getting little milk. Other potential issues - pain from stretching of inelastic scar tissue during feeding or pumping, potential injury to the sensory nerve under the areola that provokes MER. Catherine Watson Genna, IBCLC NYC *********************************************** 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(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html