Breast Surgery

Is it safe for a mother to breastfeed her infant if she has silicone breast implants?

Research is limited; however, there have been no recent reports of clinical problems in infants of mothers with silicone breast implants. In 2001, the American Academy of Pediatrics (AAP) issued a statement regarding the Transfer of Drugs and Other Chemicals into Human Milk, indicating that the Committee on Drugs felt there was insufficient evidence to justify classifying silicone implants as a contraindication to breastfeeding.

Learn more about breast implants.

Can a mother breastfeed after breast or nipple surgery?

Usually. Most mothers who have had breast or nipple surgery are able to produce some milk, but not all of these mothers will be able to produce a full milk supply for their infants. Having a full milk supply is not necessary for a successful breastfeeding experience because it is possible to supplement in a way that supports breastfeeding.

Breast Augmentation, lift, and reduction:

Breast augmentation, lift, and reduction procedures have the potential to affect the nerves and ducts within the breast, thus impacting lactation. Breast implants below the muscle usually affect milk production less than implants above the muscle. Incisions around the areola and surgical techniques that include completely detaching the areolae and nipples are more likely to cause reductions in milk production. Over time, ducts that were severed during surgery may grow back together or form new pathways, and nerves may regain functionality, enabling the mother to produce milk. A scar around the whole areola following breast reduction does not indicate complete detachment because it may have remained connected to tissue containing nerves, ducts, and blood supply. The amount of milk made will depend on the number of connected ducts and functionality of the nerves that enable lactation, as well as other factors apart from the surgery, such as hormones and milk removal. Babies of mothers who have had breast surgery should be carefully monitored for adequate weight gain. Mothers may need support to increase milk production and/or to supplement with pasteurized donor human milk or formula.

Mastectomy:

Women who have been treated for breast cancer with partial or total mastectomy may have reduced capability to breastfeed or produce breast milk. Partial or total mastectomy can result in removal of breast tissue and damage to essential nerves involved in lactation. Women with total mastectomy of one breast should plan for unilateral breastfeeding. Women with partial mastectomy and radiation therapy should expect significantly reduced milk production on the affected side(s). A single breast can produce enough breast milk for healthy infant growth. However, dyads should be followed closely for adequate infant weight gain. Further guidance is outlined in the Academy of Breastfeeding Medicine’s clinical protocol on Breast Cancer and Breastfeeding.

Women may have varied experiences with breastfeeding after breast cancer treatment and may encounter a range of social and psychological challenges. Providers may need to address psychosocial challenges when supporting the infant feeding decisions of women who have had breast cancer.

Hypoplastic breasts:

Some mothers may have had underdeveloped (hypoplastic) breasts prior to having breast surgery. Mammary hypoplasia, or insufficient glandular tissue, is characterized by breasts that appear tubular, widely-spaced, or significantly asymmetrical, leading some women with this condition to seek reconstructive surgery. Mothers who have had hypoplastic breasts may not be able to produce enough milk (primary lactation failure) and will need lactation support to learn how to stimulate production and/or how to supplement with pasteurized donor human milk or formula.

Can transgender parents who have had breast surgery breastfeed or chestfeed their infants?

Yes. Some transgender parents who have had breast/top surgery may wish to breastfeed, or chestfeed (a term used by some transgender and non-binary parents), their infants. Healthcare providers working with these families should be familiar with medical, emotional, and social aspects of gender transitions to provide optimal family-centered care and meet the nutritional needs of the infant. These families may need help with the following:

• Maximizing milk production
• Supplementing with pasteurized donor human milk or formula
• Medication to induce lactation or avoiding medications that inhibit lactation
• Suppressing lactation (for those choosing not to breastfeed or chestfeed)
• Finding appropriate lactation management support, peer support, and/or emotional support

Learn more about how to support transgender persons.