Breastfeeding after reduction surgery (BFAR)

archi35 · July 2014

I read back to older posts on TB and BFAR experiences seem very subjective depending on the person. Also it seems from what I've read, that reduction is more likely to cause difficulty in feeding or pumping more often than augmentation. I realize this topic is also a little early for where we are in our process, but its been on my mind a lot.

My history: I had two different bilateral surgeries for cyst removal and then moderate reconstruction when I was in my late teens/early twenties. The surgeries were fairly extensive in that the tissue removed was about 50% each side, and the reconstruction then shuffled more tissue back into place (so to speak simply). I am left with bilateral nipple scars and also an "anchor" on one side. In general I healed well, and have some nerve loss only on one side. I should also add that I have had EXTREME nipple pain, burning sensation, etc. since the bfp which usually means that things are at least starting to tick in there

So that's good progress I hope.

Do any STM's have any experience with BFAR? Is there anything I can really prepare at this point or am I just pre-thinking something that will end up as it will end up? Should I just let it go and talk to a lactation consultant at the hospital?

TIA Ladies - it seems I've found a new thing to obsess over this week.

jcsumm0 · July 2014

I have not personally had a reduction, but I highly recommend this book: https://www.bfar.org/book.shtml and the other info on that website. I don't think there is any reason to give up now. Many moms have great success, and the breastfeeding relationship is not just about milk. Many moms enjoy nurturing their baby at the breast even if they don't end up achieving a full milk supply.

I would contact an IBCLC or LLL leader now to make a plan for after birth, I think that will make you feel more positive about the whole thing.

I hope someone else can chime in with some more personal experience!

Emerald27 · July 2014

Definitely seek help from an IBCLC and/or La Leche League Leader in your area. Breastfeeding success after reduction surgery IS very specific to the individual mother, so setting up a consultation is a great start. Ultimately, you will just have to see what production is like for you, but a professional can help to set you up for success by providing strategies for you regarding increasing supply and knowing when/if to supplement.

Much of breastfeeding success after reduction has to do with 1. whether the milk ducts were irreparably damaged or removed during surgery, and 2. nerve damage. Were you told by your surgeon whether they were planning to remove ducts or fatty tissue from between the ducts? Also, were your incisions directed toward your nipples (like spokes on a wheel) or in circles around and parallel to your nipples? Incisions that look like spokes on a wheel generally protect the nerves and ducts better than incisions that circle the breast. How much feeling do you have in your nipples (you mentioned some nerve damage)?

Many many mothers breastfeed with great success following reduction surgery! I can PM you some resources if you like. Best of luck!

archi35 · July 2014

Emerald27 I would love the PM for additional info - thanks! I had the full circle due to to some of the cysts being closer to the nipples unfortch. But I do have what I think is full sensation on one side and I would estimate about 50% on the other comparatively. And like I said they are both en fuego this entire pregnancy so that must also be a good nerve sign. I'm not sure how much duct-work was modified or severed, but they did have to remove a lot of tissue as they types of cysts were quite fibrous and spread out so that's the biggest concern I have at this point.

vrj0522 · July 2014

I have a friend who had an extensive reduction surgery and she was still able to bf her daughter. I know it is an individual thing and while some women might be affected by surgery, others are not. I also recommend speaking to a LC to see if there is anything you can do in preparation.

golfingdarwinfish · July 2014

If you feel comfortable you may want to reach out to your surgeon as s/he knows best what they had to "move" and restructure during the surgery. Immediately after my reduction (when I was 17, so 14ish years ago) my surgeon gave me that report and said that due to the extent of her alterations she would expect that I would have some amount of difficulty (particularly because of work performed on the nipple and something else, though I forget the details as I was young and didn't really care).

Rickaroo922 · July 2014

There is a good BFAR group on facebook. I'm a BFAR mom. I had my surgery about a year before getting pregnant. Definitely read Diane West's book (Defining Your Own Success) . I was only able to get my son to latch for the first few days (aside from a handful of times). I pumped every 2-3hrs for 6mo. At my max I only produced enough for one feeding a day. I would totally see a llactation consultant. This time around I am more determined to get her to latch. I have been looking into an SNS to supplement. Look into different ways to up your supply before you need them, its nice to have them on hand.

Maggie6424 · July 2014

I had a reduction in 2007. My milk production was sad, and I gave up pumping after 5 weeks because I was only getting about 2 ounces TOTAL per day. I was pumping around the clock, too. I hope this time will be better, but obviously I'm aware of how bad it can be. I have anchors on both sides from the surgery, and they did not detach the nipples. They didn't remove near as much tissue as with yours, I think 1/3 from each side. However, my boobs are now just as friggin big as they were when I had the damn surgery. Thanks to PCOS/weight gain.
I hope your experience is better than mine! I just want you to be prepared in case it isn't what you're expecting. I was told by my surgeon that bf'ing would be no problem, and that set me up for devastation when I couldn't produce.
I did meet with an LC after the birth, and she said there's likely nothing I could've done to change what I would produce. I did try fenugreek, but it didn't help.

SweetMandyB12 · July 2014

I had a reduction 14yrs ago and was told I'd prob not be able to feed. But as a stubborn 17yr old with severe back pain at the time, I didn't care and wanted them gone. My OB seems to think it won't be a problem. I too bought the book Defining your own Success and plan to contact an LC. I know I won't be able to feed exclusively and plan to supplement with donor milk and formula. Techniques today are more forgiving for moms who want to BF, so each case is different.

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