I have recently been involved in research on the difficulties that
women who have had a reduction mammoplasty face while breastfeeding.  The
type of surgical procedure performed, whether it’s nipple transposition or
a free nipple transplant can be a factor in the ability to lactate.
Reduction mammoplasty can damage milk ducts and put these women at an
increased risk for lactation problems.  According to Hatton and Keleher
(1983), techniques of massage and expression should be taught and employed
during the third trimester.  These techniques are meant to stimulate
lactation and some mothers may even express colostrums during this time.
      In 1997, Ms. Walrond was charged with second-degree manslaughter in
the starvation death of her infant at 2 months.  She had a reduction
mammoplasty three years prior and in her record the surgery was noted
a “major potential danger” because her milk supply was insufficient at
producing enough milk to nourish her son (Bernstein, 1999).  The mother’s
argument is she wasn’t informed by the doctors about her inability to
produce an adequate milk supply.  In my research, most health care
providers suggest bottle-feeding in addition to breast-feeding for these
mothers.  In your practice do you see women that can fully nourish their
infants on their breast milk alone?  Or do they usually require additional
supplementation?
       Some of my resources are a little dated but I found there are still
differing opinions when it comes to the possibility of lactation after a
reduction mammoplasty.  Engstrom & Fridlund’s research (2000), found more
satisfying results with longer time between a reduction mammoplasty and
lactation.  In your practice do you find breast-feeding chances are more
promising when more time has lapsed from surgery to lactation?
 Bernstein, N. (1999). Trial begins for mother in breast-fed
infant’s starvation death. New York Times, April 28.
 Engstrom, B.L. & Fridlund, B. (2000). Women’s views of counseling
received in connection with breast-feeding after reduction mammoplasty.
Journal of Advanced Nursing, 32(5).
 Hatton, M. & Keleher, K.C. (1983). Breastfeeding after reduction
mammoplasty. Journal of Nurse Midwifery, 28(4), July/August.

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