Surgery and breastfeeding
A mother may have to undergo surgery for various reasons, which may have an impact on her
breastfeeding performance (also known in medical parlance as "lactation insufficiency").
Depending on the severity of the surgery, a mother may continue to breastfeed her child, or may
have to deploy breastpumps, or take recourse to formula milk. The same is true when the child has
to undergo some surgical procedure. This article looks at the various circumstances when such
surgeries are carried out, and their impact on child nursing.
Breast Reduction
Some mothers undergo surgery for the purpose of breast reduction, known as Breast Reduction Mammoplasty. Here, excess glandular tissue and fat present in the breast is removed, while retaining intact the blood supply and sensation in the remaining tissue. Depending on the briefing the mother has given to the doctor about the surgical sculpting to be carried out on her breasts, appropriate amount of tissue known as Pedical Flaps are moved. Post surgery, the amount of remaining milk-producing gland, the quality of preservation of gland attachments to the nipple, and sensation issues together decide how well the mother is capable of breastfeeding.
In extreme cases, when massive mammoplasty has to be carried out, the nipple and areola are disconnected from the underlying gland, nerves and blood vessels. In such a case, breast feeding is quite difficult, if not impossible.
Breast Enlargement
The other end of the pendulum is where mothers have to undergo breast augmentation (BAM) or enlargement. This is done through a breast implant, which is a sac of silicone elastomer that is filled with either saline or silicone. The sac is implanted under the breast tissue.
Silicone has traditionally been the dominant implant thus far, but in the past decade-and-half, issues about autoimmune-mediated health problems associated with leakage have brought saline to the fore. Leakages of silicone are usually found in secondary tissue; and while silicone imparts a softer look to the breast than saline, saline leakages are a lesser devil, as they are simply absorbed by the body.
Besides the type of implant, the location of the implant also makes a difference to breastfeeding capability. Out of the four areas of incision - Periareola, Sub-mammary, Axillary and trans-umbilical - it is the periareola where there are chances of higher damage to nipple sensation. Studies carried out by the Institute of Medicine (IOM) have shown lactation insufficiency in mother-baby pairs where nipple-area incisions were carried out. The outward effect of this insufficiency is visible in a reduced acceleration in daily weight gain by the babies. Reasons why breast implants should cause breastfeeding problems are not fully known; though one conjecture is that the implant might be putting pressure on the breast tissue, thereby damaging the latter and leading to reduced milk production. There are further reports of breast implants leading to mastitis, galactocele and the like.
Child Surgery
There are occasions when the baby has to undergo surgery, or some sort of hospitalization for a limited or prolonged period. In such a situation, breastfeeding has to stop for some time before, during, and after surgery. An empty stomach is more comfortable for the child being taken to the operation table; for the anesthetic injected into it can induce nausea and vomiting if the child has been recently breastfed. This is something that the mother should consult with the physician performing the surgery.
The physician also needs to be consulted for the time when breastfeeding can be resumed, "after" the surgery is over.
Since this implies that one or more of the mother's nursing sessions are going to be skipped, it might be wise to make use of a breastpump to express the milk being produced during this time, and either store the same for later use, or dump it. This helps in preventing any engorgement-related problems, and continuous supply is assured.