One of the many things that I was surprised by when I was pregnant with my older son (OS) was how little my ob/gyn and the nurses seem to know about breastfeeding after a breast reduction (BFAR). While I do not have any current stats on how common breast reductions are or how common it is to have them before having kids, I know that it is not an unusual procedure. However, the reality was there wasn't a lot of information out there. I did speak with a lactation consultant when I was pregnant who not only told me that a good electric breast pump would be helpful, but that my insurance company would probably pay for it. She was right. She recommended one other thing: a book called Defining Your Success by Diane West which is about breastfeeding after a breast reduction surgery. People swear by it (at least in the reviews I read from Amazon.com). I tried to order it on-line, but at the time it was out of print. I eventually did get a copy of it before I had my second son. I was glad that I looked at it, and I'm glad that there's a book about BFAR out there. I think it's important to know that this book exists, but I personally didn't like it. More on that in a different post.
Shortly after this conversation, a La Leche leader who is a friend of my mom told me about a support group called BFAR. This group stands for breastfeeding after breast reduction. Despite my personal discomfort with this web site, there are testimonials from women in the group about how valuable it has been to them. That is why I'm posting about it. On the positive side, I like the fact that they provide an opportunity to discuss breastfeeding with someone who had also had a breast reduction. It would have been nice to know someone who's in the same boat. More importantly, they do have a lot of resources which, as I said above, is unusual. They also give information on what you can do to increase your chances of breastfeeding while you're pregnant.
What I didn't like about the site was the emphasis on regret. It appeared that it was more of an "I'm sorry I had a breast reduction" group. I am not sorry that I had breast reduction surgery. I also felt the site could seriously undermine any pregnant woman or new mom's confidence in her ability to breastfeed. Since to me confidence is an important component of being able to successfully breastfeed, I didn't think this group was a good match for me.
I recently checked out the website again, since it's been a few years, and I struggled most with a section about breast reduction surgery called "Should you have it?" I didn't like the way the site put all of the testimonials from women who were sorry that they had breast reductions at the top. The ones who weren't sorry were more hidden at the end. I feel that there is enough guilt that goes along with just being a parent. I don't need to start questioning a decision that I have always felt was best for me. I viewed it as medically necessary (hey, my insurance company certainly agreed) end of story. I also think discussing breastfeeding in a group that is at least as focused on regret as on supporting breastfeeding when I was having difficulty breastfeeding would have really put me in a black hole.
My efforts to breastfeed made me miserable, and, like I've posted before, the lactation consultant who visited me 4 times was the one who told me it was time to move on. Having her "blessing" made it a lot easier for me to let go. I know that if I had been around people who were telling me to keep trying, it would have been much harder. Ultimately, I was much happier being a mother when I switched over to formula. Ever since I became pregnant, I asked myself this particular question when I'm in a tough situation: "Will _ make me a better mother?" For me, breastfeeding, or more correctly my lack of ability to breastfeed, not only resulted in my son having a trip to the ER for severe weight loss, but it made me not enjoy being a mom because I was depressed, oversensitive and very irritable (not to mention consumed with guilt). That's not to say that I didn't have guilt when I started to formula feed (and quite frankly for a long time after) but at least I was happy and also equally importantly my baby was happy.
I emailed Suzanne today about a recollection that had made me feel better about formula feeding: When OS was a newborn my mom came out to help, and she bottle fed his supplements to him for me to give me a break. It helped me feel removed from the situation and made me able to see it through "new eyes," so to speak. When I saw how happy and content he was after eating, I felt better. My breastfeeding with my younger son (YS) had all the early hallmarks of success. However, he also started to lose a lot of weight. When I was told he needed to have a bottle in the hospital, I cried. At 3 in the morning my very supportive husband and I went to the nursery to "spy" on the nurse who was feeding YS. YS just looked so peaceful that I immediately felt better. Just like with OS, I gave him breastmilk and formula for 5 weeks until my milk dried up. With YS I was then able to move on to just formula leaving the guilt behind this time. Everyone around me was very supportive.
The part of the web site most evocative of guilt was the section where they talk about whether future moms should hold off on surgery until after they are done having babies, saying
"As mothers, we have to make hard choices and we often have to make some sacrifices to give the best for our children. This is one area that you can make a personal sacrifice that will have HUGE rewards. You can put off this surgery for a few years and give your children the incredible benefit of exclusive nursing (meaning without supplementation)."
At no time during my breastfeeding hell did it ever occur to me that I should have waited until after I had kids to have the surgery. Nor did anyone even suggest this to me directly. To ask women to live through years of pain, potential long-term physical harm, low self-esteem, and sexual harassment does not seem like a fair sacrifice to request. It also presupposes that a woman's complete control over her ability to have a child and over her physical ability to breastfeed absent breast surgery. Neither of these are guarantees, and it also begs the question, how long should a nineteen-year-old woman who is unsure about her childbearing plans wait? Is ten years of sacrifice long enough if she has not had a child by the age of 29? How about twenty years, if she has not had a child by 39? What if a woman subjects herself to twenty years of discomfort and then cannot get pregnant or has a baby but cannot breastfeed for other reasons. Talk about regret!
I was genuinely taken aback when I read the testimonials from women regretting their decision. This simply was not my experience. That is why I did not feel that this group was a good fit for me.
i too read the diane west book and visited the BFAR site before signal was born. and i completely agree with you. nearly everything i read was from women who said they regretted their reductions. and i do not.
even after the reduction (which i had 10 years ago when i was 17), i am a DD. and while pregnant with signal, my chest grew to an F cup. my back used to hurt all the time. and although at 17 they told my i might not be able to breastfeed, i gladly went ahead with the surgery.
signal was never able to latch properly, so i pumped with a hospital grade pump for 4 weeks and supplemented what i pumped with formula. after 4 weeks, my supply completely dried up.
i have to say that i am still a bit sad about it all. for me the idea of breastfeeding was more about bonding than nutrition. i think that if signal had latched, i would have felt better. if ru and i have a second, i'll try again. but i am realistic.
so know that you are definitely not alone. there are BFAR moms out there that don't regret their reductions. far more than you or i know about, i suspect.
To make women second guess themselves is outrageous, offensive, and ridiculous. It is true that parents (not just moms) need to make sacrifices for their kids, but to insist that living with excrutiating back pain is beyond anti-woman. (I'd also point out that such pain may prevent women from holding their babies, which hardly seems in the child's best interest.)
I will never regret having breast reduction surgery. It was one of the best decisions I ever made, period. And I resent the implication that my mother, who formula fed me, did not have my best interesets at heart. I seem to have come out just fine, as has my husband who was also formula fed.
Sorry I'm three months late to this. I had a breast reduction several years ago, knowing it might be years before I had kids, and knowing too that it might interfere with my ability to breastfeed. I want to breastfeed and I think it's valuable, but I also knew then and still believe now that the surgery was the right decision for so many reasons. I don't imagine I won't suffer ANY guilt (I hear guilt comes with the pareneting territory), but I also know I am going to be a good parent, boobie milk or no. I'm willing to take a breath and say "This is a thing I can't do. I'm okay. Baby will be okay." Thanks for writing about this. Fascinating topic. I'll have to chat with you from the doll bed about it... I hear I'm sleeping in it.
This post made me tear up a little bit. (Er, sorry I'm so late! I just found your blog.) I had a reduction a little under six years ago, when I was not quite 19. It was covered by my insurance company and one of the best decisions I've ever made. I never even considered regretting the surgery until I found the BFAR site, several years after my surgery.
That site scared me so badly. I have always wanted to breastfeed, and my surgeon reassured me before the surgery that I would be able to. When I think about my reduction now I get all twisted up inside, grateful that I have moderately smaller breasts (though! They're gone up a size and a half since the surgery and not due to excessive weight gain! wtf!) and terrified that I made the wrong choice based on information I simply didn't have.
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Professional Mom of two cats, a dog, an ant farm, and oh yeah...two boys: a 6 year old and a 3 year old. Also found in my house is my husband who is known on this blog as The Big Giraffe.
For those of us who didn't get an instruction manual with our babies and for whom parenting hasn't always gone as planned. On a more serious note this blog is about supporting a woman's ability to make her own choices about parenting including the choice, for whatever reason, to bottle feed her babies formula.
m here.
i too read the diane west book and visited the BFAR site before signal was born. and i completely agree with you. nearly everything i read was from women who said they regretted their reductions. and i do not.
even after the reduction (which i had 10 years ago when i was 17), i am a DD. and while pregnant with signal, my chest grew to an F cup. my back used to hurt all the time. and although at 17 they told my i might not be able to breastfeed, i gladly went ahead with the surgery.
signal was never able to latch properly, so i pumped with a hospital grade pump for 4 weeks and supplemented what i pumped with formula. after 4 weeks, my supply completely dried up.
i have to say that i am still a bit sad about it all. for me the idea of breastfeeding was more about bonding than nutrition. i think that if signal had latched, i would have felt better. if ru and i have a second, i'll try again. but i am realistic.
so know that you are definitely not alone. there are BFAR moms out there that don't regret their reductions. far more than you or i know about, i suspect.