Breastfeeding and Implants

As with many health questions, this is an issue fraught with controversy and best discussed with your doctor. The answer ultimately depends upon the specifics of the case. That said, there are two major concerns with implants and breastfeeding: whether the breast will still produce milk, and if breastfeeding with implants is safe for the baby. The location of the incision made to insert the implants and the skill of the surgeon play a large role in determining if the breast is still capable of producing enough milk. One lactation consultant states, "Incisions made in the fold below the breast rarely interfere with breastfeeding. Incisions made in the armpits -- if the surgeon is careful to avoid nerves -- are not likely to interfere." If, however, the nerves or breast tissue are damaged, as can happen when the incision is made around the areola, you may have problems producing enough milk. Occasionally, scarring from implants may also make breastfeeding uncomfortable or even painful.

Many sources on the Web that echoed this claim, including an article from the National Resource Center for Women and Families that states "any kind of breast surgery, including breast implant surgery, makes it at least three times more likely that a woman trying to breastfeed will have an inadequate milk supply."

As far as safety is concerned, the newer saline implants are not generally considered a risk. The data is a little less clear regarding the older silicone implants.  Overall, many experts seem to feel that "the benefits of breastfeeding far outweigh any risk of problems" and encourage women with implants to try breastfeeding. 

Breastfeeding Myths
Written by Jack Newman, MD, FRCPC

Note:  I only took excerpts from this particular article as to what what might be most helpful in addressing the issue of milk production and implants...

Not true! Most do very well. There is no evidence that breastfeeding with silicone implants is harmful to the baby. Occasionally this operation is done through the areola. These women do have problems with milk supply, as does any woman who has an incision around the areolar line.

Not true! Breast reduction surgery does decrease the mother's capacity to produce milk, but since many mothers produce more than enough milk, mothers who have had breast reduction surgery sometimes manage very well to breastfeed exclusively. In such a situation, the establishment of breastfeeding should be done with special care to the principles mentioned in the handout #1 Breastfeeding—Starting Out Right. However, if the mother seems not to produce enough, she can still breastfeed, supplementing with a lactation aid (so that artificial nipples do not interfere with breastfeeding).

This article may be copied and distributed without further permission

Handout #12 More Breastfeeding Myths. Revised January 1998

About the Author

JACK NEWMAN graduated from the University of Toronto medical school as a pediatrician in 1970. He started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's Hospital for Sick Children. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa, and has published articles on the subject of breastfeeding in Scientific American and several medical journals. Dr. Newman has practiced as a physician in Canada, New Zealand, and South Africa.

Q&A with Cher Sealy, RN, BSN, IBCLC, LLLL

Q: I had breast surgery to correct uneven breasts.  The surgery involved reduction on one side and augmentation (saline implant) on the other. I was told I would not be able to know if I could breastfeed until I actually tried.  Now it has been recommended to me that I not even try breastfeeding because this may lead to infection or a leaky implant. Can you help?

A: You say it has been recommended to you that you not even try breastfeeding because it may lead to infection or a leaky implant. I don't know who gave you this advice, but it is not based on any research I know of. There is no reason to believe that breastfeeding will cause implants to leak, and breastfeeding is not going to cause infection.

Millions of women have breast implants, and many of these women have breastfed their babies. You say you have saline implants, but even with silicone, there is no evidence that the silicone used in implants can pass into the milk. Since most implants are inserted through incisions under the breast or in the armpit, it is very unlikely that any milk ducts would have been severed. However, one problem with implants is that they put you more at risk for problems with engorgement.  Educate yourself about how to prevent and treat engorgement so that you will reduce the chances.

With reduction surgery, it is much more likely that nerves may be damaged or milk ducts cut. As time passes, milk ducts can grow back, nerves can repair themselves, and sensitivity can return.

The most important thing you can do is to educate yourself about breastfeeding in general and signs of adequate intake (wet diapers and stools, etc.) Also realize that it is possible to entirely sustain a baby with only one breast.

Get in touch with a local lactation consultant and La Leche League. La Leche League has a pamphlet called "Nursing with Breast Implants." Also, La Leche League's book, "The Womanly Art of Breastfeeding", discusses all these issues. 

It is true that you will not know whether you can successfully breastfeed until you try it. However, there is certainly a very good chance that you can. Even if you find that your supply is not adequate, a nursing supplementer can enable you to continue feeding your baby at the breast.  Good luck!

- Cher Sealy, RN, BSN, IBCLC, LLLL

Q&A with Yvonne C. Bannister, B Sc, CBC, LLLL, IBCLC

Q: I'm 21 weeks and am due in November and I want to know how far ahead should I start taking Fenugreek...I had a breast reduction about 6 years ago...I was told I couldn't breast feed, but I do believe I will be able to produce some milk for my baby. I have been giving myself breast massage and have produced some liquid. So, I just wanna make sure I'm doing all I can to insure that I can breast feed!

A:  One of the questions I have for you is who told you that you were not going to be able to breastfeed? I wonder if it is possible to find out from the doctor who did your surgery what kind of cuts he made to your breast, the more information that you are able to find out ahead of time the better informed you will be when the time comes.

I also recommend that you find a good breastfeeding book such as "The Womanly Art of Breastfeeding" by La Leche League so that you can read as much as you can about breastfeeding before the baby is born. Knowing the signs to look for to let you know that your baby is doing well at breastfeeding will help you immensely in your self confidence.

Also, keep in mind that just because you had breast reduction surgery does not guarantee that you will not produce enough breast milk for your baby. There have been cases of woman's milk ducts "recanalizing" or growing back after they were cut. In my opinion, it is not a good idea to recommend Fenugreek at this time. First find out about the type of surgery that you had, then find out about breastfeeding in general for all women regardless of surgery, then be ready just incase you do need to increase your supply by pumping and maybe Fenugreek or another aid.

It is important to know that depending on the type of surgery, you may be able to produce a full milk supply for your baby but depending on the type of surgery the baby may not be able to get the milk due to the type of cut so that the milk can simply not pass through. The more breast tissue that was removed, the less likely that you may be able to fully breastfeed your baby and if your nipples were removed your chances may be less. However, the only true way of finding out if you can or cannot feed your baby is by giving it a try and being very well informed about breastfeeding. Good luck.

- Yvonne C. Bannister, B Sc, CBC, LLLL, IBCLC

Q&A with Ann Calandro BSN, RNC, IBCLC Lactation Consultant

Q: Is it safe to breastfeed with saline breast implants? Mine are implanted under the muscle and the plastic surgeon insists there should be no problem. Is this true, and can it have an ill effect on the milk?

A:  Yes, it is safe to breastfeed with saline breast implants. Saline is a natural substance, like tears. Implants do not have an ill effect on breastmilk. At times, however, the surgery itself may cause problems.

If the implants were inserted from under the armpit or in the fold under the breasts, it is likely that the nerves important to breastfeeding have not been damaged. If they were inserted from an incision around the areola, there may be problems with milk supply. Sometimes there is scarring inside the breast, which in severe cases may cause some discomfort during breastfeeding.

It is also important to understand why the implants were done. If the breasts were normally developed, but augmented for personal reasons, there is likely plenty of breast tissue and milk ducts. If the augmentation was done because there was little or no breast development, it is possible that there may not be sufficient milk ducts to breastfeed. In this case, Mom should go ahead and breastfeed after giving birth, carefully monitoring the baby to assure he is getting sufficient milk.

- Ann Calandro BSN, RNC, IBCLC Lactation Consultant

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