Nursing with Implants

By

Barbara Behrmann, Ph.D. © 2006

I was standing in line at the grocery store with my then eight year old when I saw her staring at the end display of magazines.  “Watcha looking at?” I asked, though I was pretty sure I knew the answer.

 “Nothing,” she quickly replied.

 “Are you looking at the woman on that cover?” I gently probed, nodding toward a thin model with enormous breasts.

She nodded, almost guiltily.

I then tried to introduce her, in an age-appropriate way, to the reality of breast implants.

We know that the biological purpose of breasts is for nursing children. But it’s sometimes hard to remember that in a culture as incredibly breast-obsessed as the U.S.  In our quick-fix, one-size-fits-all society, more and more women have been altering their bodies in recent years to meet the cultural standard du jour.  In fact, the percentage of women who have had breast implants increased 676% from 1992 to 2004.  And the vast majority of women have had them before having children.

What does this mean for breastfeeding?  Can you still nurse if you have artificially enlarged your breasts?  Well, that depends. 

What are the Issues?

Uncertainty centers around three issues:  the safety of nursing, a woman’s ability to produce a full supply of milk, and the ability of the milk to flow through the nipple.

Safety

No indisputable link between implants and harm to babies has ever been established.  Moreover, a 1998 study found that the silicone levels in cows milk was 10 times higher than in breastmilk, and even higher in infant formula.  On the other hand, Susan M. Zimmerman, author of “Silicone Survivors:  Women’s Experiences with Breast Implants,” mentions a woman from Long Island who found over 50 cases of children afflicted with strange symptoms after they were breastfed. All their mothers had received implants prior to pregnancy.

Still, there is less information available about the safety of nursing with implants than there is about the risks of using formula.  Thus, many women who have successfully nursed with implants regret neither their decision to have had them, nor their decision to nurse.  Ultimately, it is up to each woman to weigh the pros and cons of her decision.  An excellent bibliography of information about breast implants is available at: www.lalecheleague.org/cbi/bibimplant.html

Milk Production and Delivery

Whether or not you will be able to provide your baby with a full supply of milk depends, in part, on the type and location of the incision used and whether the implants are placed on top of your chest muscles or beneath them.  Both silicone and saline implants are implanted under the breast tissue, but some are placed on top of the chest muscles, while others are placed under the muscles.  It is unclear to what extent the implants may put pressure on the milk-producing glands, which in turn, may lead to a decrease in milk production.  Surgeons and lactation consultants alike feel that this is more likely to be a problem when the implants are placed above the muscles, but this based on speculation, not evidence.

As far as the incision goes, if you’ve had a periareolar incision (around the nipple) you may be more likely to experience difficulties than if your incision is under your breast or near your arm pit.  Cutting the areola is more likely to sever the milk ducts, meaning that although women may produce milk, the milk can’t flow well through to the nipple.   

A Dearth of Studies

Unfortunately, no well-designed studies have critically examined these issues.  Nor are there statistics concerning trends in the kind of implant surgeries women receive. The American Society of Plastic Surgeons, the largest plastic surgery organization in the world, does not track this.  Recommendations are typically based on limited research, a surgeon’s own assumptions, and anecdotal evidence. 

While it may not be in their economic interest to emphasize breastfeeding, plastic surgeons should not minimize its importance.  Nor should they minimize possible risks.  I quote here from a website created by The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons:  “The presence of a breast implant will have no effect on your ability to become pregnant, deliver a baby, or even breastfeed. Breast implants have not been shown to have an effect on children or future offspring.”  Yet scroll down a bit and you’ll find the following:  “…It is not known if there are increased risks in nursing for a woman with breast implants. Implant placement techniques that involve incisions through the nipple and areola locations may reduce the ability to successfully breastfeed.”

Personally, in a culture that uses scientific evidence as the basis for recommending all sorts of health behaviors, I find it shocking that so little research exists concerning the possible relationships between breast implants (not to mention other breast surgeries) and the ability to lactate.   Why isn’t the biological functioning of the breast included as part of the medical training and education of plastic surgeons?  Why do they not have information concerning the health risks that come from not breastfeeding?  Why has the medical community not undertaken any large, well-designed studies that examine the relationship between breast implants and the ability to breastfeed?

The fact that the medical community has given so little thought as to how surgical procedures could potentially obstruct women’s ability to nurse reflects an unjustifiable disregard for the well-being of women and children.  Small breasts are not a disease, as the American Society of Plastic and Reconstructive Surgeons, has told the Food and Drug Administration.  Yet there are known risks of feeding babies formula.  And while you may indeed be able to breastfeed your baby successfully, you – and every woman - deserve to make choices based on scientific evidence, not conjecture.

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Barbara L. Behrmann, Ph.D. is a writer, researcher, and author of The Breastfeeding Café: Mothers Share the Joys, Secrets & Challenges of Nursing, University of Michigan Press, 2005. She is a frequent speaker around the country and is available for talks, readings, and conducting birthing and breastfeeding writing circles. The mother of two formerly breastfed children, Barbara lives in upstate New York.