Breast Reductions and Breastfeeding
Women who have had a breast reduction are at greater risk of low milk supply.
But wait - My surgeon said it would be fine! Guess what - They don’t understand lactation! They are a plastic surgeon, not a lactation consultant!
Let me explain. There was an article this morning about breast reductions in Australia and a little line caught my eye.
I quote - “All of the common surgical techniques keep the nipple attached to the underlying breast tissue, so the chances of feeding a baby in the future remain good,” Dr Morgan says.
I call BS Guys!!!!
I have supported many women who have undergone breast reduction surgery. Far too often, they were reassured beforehand that breastfeeding would not be a problem. Unfortunately, this is deeply misleading. Many are devastated when they later discover they cannot feed their babies as they had hoped. The emotional impact can be profound, with guilt and grief compounding their struggles—particularly as the decision to have surgery is often made at a young age, long before considerations around breastfeeding arise.
The impact of breast reduction surgery on lactation is significant and multifaceted:
Loss of glandular tissue – The removal of milk-producing tissue directly reduces a woman’s ability to make milk. Think about it, this tissue is our milk makers, you remove it or tamper with it, it’s gone. Some may remain which may result in some milk.
Disruption of ducts – Repositioning of the nipple often severs the delicate network of ducts responsible for transporting milk. Think about it - Imagine a very large breast, remove a bunch of tissue and then look at the nipple, where is it? Probably quite low and needs to be cut off and re-sewn back on in a new location. Behind that nipple is nerves and ducts that are the transport system for the milk through the nipple. Some may regrow over time but you still may not receive a full supply.
Reduced nipple sensation – Nerve damage diminishes sensation, which is crucial for triggering the oxytocin response needed for milk ejection. Baby comes to the breast, they stimulate the nipple which stimulates oxytocin response in Mums brain, that is the hormone responsible for the let down of milk. No oxytocin, no milk.
Infant risk – Babies may fail to gain weight, with plummeting newborn weight posing a serious health risk—especially when mothers are led to believe there will be no problems. No milk, no weight gain.
While some women may produce small amounts of milk—particularly if many years have passed since surgery, allowing some reconnection of ducts—most women will never achieve a full supply. And it is absolutely devastating.
I fully respect and have no objection to women choosing this surgery for themselves. However, what is deeply concerning is that they are not being given full and accurate information about the impact on breastfeeding. Without this, informed consent is not occurring. Also, we need to remember that women are commonly having these surgeries from a young age before that understand what breastfeeding will mean to them.
If you are in this situation, please reach out to an IBCLC near you or I am available for a Zoom consultation. We can then measure and decide the best course of action to keep your baby fed whilst achieving what you can with breastfeeding.
Much love mamas
Peta x