Dear Lactation Consultant,
I breastfed both of my kids, now seven and three years old, with no problem. I got breast implants about a year and a half ago and I was wondering if I might expect any problems breastfeeding with implants.
I am five weeks pregnant and I really want to breastfeed this baby also.
Any woman who has had breast, chest, or cardiac surgery should check with her surgeon to see if any functional breast tissue was affected by the procedure. Breast augmentation usually doesn't involve severing milk ducts or destruction of functional breast tissue, and is usually compatible with lactation. On the other hand, breast reduction is a much more invasive surgery that almost always has an adverse effect on lactation.Anytime a surgeon performs invasive surgery on the breasts, there is the possibility of damage to the milk ducts, and some mothers who have had implants do experience problems with milk supply, plugged ducts, and engorgement. These problems are usually fairly minor, and rarely prevent the mother from breastfeeding successfully.
A lot depends on whether or not the surgeon who performed the procedure made a deliberate effort to leave the blood supply and nerve pathways intact. If the incision is made around the areola, rather than under the breast or armpit, then there is more of a risk of breastfeeding problems and a loss of sensation.
Most implants now are filled with saline rather than silicone. There has been a lot of concern about silicone implants leaking into the breastmilk, but studies have shown that the risk is small and the benefits of breastfeeding outweigh the risk of silicone leakage. There is about a 1.5% chance that the implants will leak, but since silicone isn't absorbed into the GI tract, it is unlikely that it would get into your milk.
Mothers who have had breast surgery need to closely monitor the baby's weight gain to establish the potential need for supplemental feedings. Chances are that you will not encounter serious problems with nursing, but even if it turns out that enough milk ducts have been damaged to significantly reduce your milk production, you can still breastfeed while offering supplements. Nursing is more than just a feeding method, so your baby can still derive the emotional as well as nutritional benefits of breastmilk even if you don't produce enough breastmilk to feed him exclusively.
All the best,
-- Anne, IBCLC