Moms who have had breast reduction, breast implants, and other breast surgeries face some specific Booby Traps.
To develop a good list of these barriers, I spoke with Diana West, IBCLC, author many books on breastfeeding, including Defining Your Own Success: Breastfeeding after Breast Reduction Surgery, The Breastfeeding Mother’s Guide to Making More Milk, and The Womanly Art of Breastfeeding, and founder of the websites bfar.org (for breastfeeding after reduction surgery) and lowmilksupply.org.
In this interview, we discussed the breastfeeding barriers moms face after breast surgeries:
The first barrier that many women run into is the mismatch between reality and what their surgeons have told them. Many times when women go to have breast reduction, breast augmentation, breast lift, or even breast biopsy, the surgeons will tell them either that it will have no effect on breastfeeding whatsoever, or ‘you can’t breastfeed at all.’ In my case, I was told I could not breastfeed. Neither of these things is usually the case. It’s often somewhere in between.
The other thing moms hear [specifically after a breast reduction surgery] is “you’ll have a 50/50 chance of being able to breastfeed.” That is absolutely unfounded in any science whatsoever. To put it kindly, it’s a surgeon’s urban myth. What the surgeons usually mean by this is you’ll have a 50% chance of having a full milk supply. Again, this is not based in any science whatsoever. What mothers often hear is “you’ll have a 50/50 chance of having any milk at all, or being able to breastfeed.” But that’s not true, either. Saying moms will have 50/50 chance of breastfeeding is just meaningless.
Most plastic surgeons, maybe unless they’ve breastfed their own kids, don’t generally address breastfeeding very much at all. They don’t understand it; they don’t give enough information. It would be ideal if the plastic surgeons’ professional organizations had information to give to mothers that explains the risks, realities, and positive outcomes. Since they haven’t created anything like this yet, the bfar.org website was developed to provide women with this important information both before and after their surgeries.
What mothers need to understand is that – depending on many factors, including the type of surgery, the time since the surgery, and her innate anatomy and physiology – there is a very real chance that they won’t have a full milk supply at least initially without any measures to increase it. However, mothers breastfeed all the time without a full milk supply and have a great breastfeeding relationship. It’s just a matter of the milk, which is ultimately the least important part of the breastfeeding experience. That’s not what most mothers believe at first, but once you get into it you realize that there’s so much more to it than just the milk.
The second Booby Trap is that mothers often assume that the problems they’re having are related to their surgery. But as those of us who work with moms every day know, there are a a lot of reasons why women have problems breastfeeding. There could be a baby-side problem, like tongue tie, or maybe the mom has had tremendous amounts of IV fluids in labor and that makes her breasts so edemetous that she just can’t get the baby to latch. Or maybe there is some underlying hyperplasia where she doesn’t have enough glandular tissue – this is very common in women who have augmentations. There could be an underlying hormonal issue like thyroid or PCOS. There are many different reasons why mothers have trouble breastfeeding or making enough milk.
Diana also discussed the importance of working with a lactation consultant who has special expertise in low milk supply. Her website lists consultants around the world who have self-identified as having this specialty, and those whom she personally knows are listed with a “Diana Recommends” badge.
They need to work with not only an IBCLC but someone who specializes in low milk production. Most hospital based lactation consultants are generalists. So working with a private practice lactation consultant who really gets the special challenges of low milk production and really understands the what needs to be done - extra milk removal in the beginning to calibrate a strong milk supply being key – is paramount. Insurance is paying for this more now, which is great. And also the book The Breastfeeding Mother’s Guide to Making More Milk is a resource which allows a mothers to empower themselves.
The Booby Trap here is that few hospitals provide referrals for this kind of specialized help. According to the CDC, in 2009 only one in four met the benchmark for providing good support and referrals to moms once they leave the hospital – one of the Ten Steps to Successful Breastfeeding. In 2009, only 27% of hospitals reported that they provided referrals to outpatient breastfeeding support in the community. So at a critical time to support breastfeeding moms who have had breast surgeries, our hospitals are too often falling short. Diana’s website referral list is her attempt to bridge this gap.
Did you have breast surgery? Did you experience any of these Booby Traps?