Silicone breast implants
The research is limited; however, there are no recent reports of clinical problems in infants of mothers with silicone breast implants. ONE declaration from 2001 from the American Academy of Pediatrics indicated insufficient evidence to classify silicone implants as a contraindication for not breastfeeding.
Breast or nipple surgery
Most mothers who have had breast or breast surgery can produce some milk, but they may not produce a full milk supply. Women without a full milk supply can still breastfeed. However, it may be necessary to supplement their breast milk with formula or pasteurized human donor milk.
Breast augmentation, lift and reduction
Breast augmentation, lift and reduction procedures can affect the nerves and channels in the breast and thus affect breastfeeding. Breast implants below the muscle usually affect milk production less than implants above the muscle.
Incisions around the areola and surgery that completely detaches the areolae and nipples are more likely to cause reductions in milk production. Over time, ducts cut during surgery can grow back together or form new pathways. Nerves can regain functionality, enabling the mother to produce milk.
A scar around the entire areola after breast reduction does not indicate complete detachment. The areola may have remained connected to tissue containing nerves, ducts, and blood supply.
The amount of milk produced will depend on the number of connected ducts and function of nerves that enable lactation. Factors other than surgery, such as hormones and milk removal, can also affect milk production.
Babies of mothers who have had breast surgery should be closely monitored for adequate weight gain. Mothers may need support to increase milk production and/or to supplement with pasteurized donor breast milk or infant formula.
Mastectomy
Women who have been treated for breast cancer with partial or total mastectomy may have a reduced ability to breastfeed or produce breast milk. Partial or total mastectomy can result in the removal of breast tissue and damage to essential nerves involved in breastfeeding.
Women with total mastectomy of one breast can breastfeed from the unaffected breast. Women with partial mastectomy and radiotherapy should expect significantly reduced milk production on the affected side(s). A single breast can produce enough breast milk for healthy infant growth. However, the infant’s weight should be monitored closely. See further guidance in Academy of Breastfeeding Medicine Clinical Protocol.
Women may have different experiences with breastfeeding after breast cancer treatment. They may also experience a number of social and psychological challenges. Providers may need to address psychosocial challenges when supporting infant feeding decisions in women who have had breast cancer.
Hypoplastic breasts
Some mothers may have had underdeveloped (hypoplastic) breasts prior to breast surgery. Breast hypoplasia, or insufficient glandular tissue, is characterized by breasts that appear tubular, widely spaced, or significantly asymmetrical. Some women with this condition seek reconstructive surgery. Mothers who have had hypoplastic breasts may not be able to produce enough milk for their infants (primary lactational failure). They will need breastfeeding support to learn how to stimulate production and/or to supplement with pasteurized donor breast milk or formula.
