Pregnancy after Breast Reduction Surgery

Implications for Pregnancy after Breast Reduction Surgery

Changes in your breasts will not affect your chances of getting pregnant. The hormones that are important for fertility come from your ovaries and your adrenal glands, not your breasts. However, breast reduction surgery can affect your ability to breastfeed.

How Breast Reduction Is Done

The specifics of breast reduction surgery depend on the shape and size of a woman's breasts. In general, breast reduction requires removal of internal breast tissue and some overlying skin, with repositioning of the nipple to match the new breast shape. Overly-large nipples can also be reduced in size.

Some women are candidates for breast liposuction instead of a reduction. This involves making a single small incision in each breast and using a thin tube to remove excess fat tissue.

Breast Reduction and Breastfeeding

Most types of surgery raise and reposition the nipples without detaching them from the underlying tissue. This preserves sensation and also allows for the possibility of breastfeeding. For women with very large or pendulous breasts, however, repositioning may require cutting the nerves and ducts that connect to the nipples. When this is done, breastfeeding is no longer an option.

Even when breastfeeding is still possible, breast reduction surgery does increase the risk of insufficient milk supply. Breasts contain special cells that produce milk, plus ducts to carry the milk down to the nipple. When breast tissue is removed, some of those ducts are removed with it.

If you're planning a pregnancy after breast reduction surgery, be sure to tell your doctor. He or she should be able to select a procedure that will maximize your chances of being able to breastfeed. If the doctor advises you that the surgery will make breastfeeding impossible and breastfeeding is something you want to do, you may want to consider delaying surgery until after you have finished having children.

If Your Milk Supply Is Affected

During a pregnancy after breast reduction surgery, many women worry about being able to provide enough milk for the baby. But even if you've had breast reduction surgery and aren't able to make enough milk for your baby, you don't necessarily have to give up breastfeeding. Your pediatrician can help you work out a plan to supplement your breast milk with bottle feedings.

Keeping an Eye on the Baby

After you give birth, you'll be visiting the pediatrician regularly to get the baby's immunizations and to make sure he or she is growing properly. The pediatrician will weigh the baby and plot his growth on a special chart. As long as your baby isn't smaller than normal, you're probably feeding her just fine.

The first appointment after leaving the hospital will usually be when the baby is two weeks old. That can seem like an awfully long time to wait if you're worried! Many moms have trouble getting the hang of breastfeeding during the first few days. If you're feeling the least bit worried that your baby isn't getting enough milk, pick up the phone and call your pediatrician. You and your baby might just need a little training, or you might need to add some formula feedings.

Signs to Look For

Here are some tips about normal breastfeeding and newborns:

• Early weight loss doesn't always mean there's a problem. Most babies will lose a few ounces after birth, but return to birth weight after about a week and then start growing.
• A normal baby will be hungry often, even if you're making plenty of milk. As little as two hours between feedings is normal.
• Well-fed babies make plenty of wet diapers. During the first six days, a well-fed baby will have approximately one wet diaper per day of life. That's one diaper on the first day, three on the third day, and so on. By day six, you should be changing diapers every few hours. Bowel movements are a little less frequent; look for two by the second day, four by the sixth day.
• Sleeping through the night isn't normal. A healthy newborn baby should wake up hungry at least once every few hours.

Call the doctor if the baby's mouth is dry, if he isn't waking up every few hours to eat, if he's not making enough wet diapers, or if you have any other concerns.