Expert: Jennifer Herrin, RN, IBCLC - 1/15/2005

Question
I am due in April and am trying to prepare as much as possible to try breastfeeding again. This is my third child and with the first one I produced too much milk and she had an upper GI when she was 3 days old and we found out she has Acid Reflux and I could no longer breastfeed. With the second child I quit producing milk. I was diagnosed with Fibrocystic Breast Disease at the age of 16 and had a tumor removed. I was told it would not interfere with breastfeeding but the side I had surgery on I have an extremeley hard time feeding on. What can I do and how does it effect breastfeeding?

Answer
Hi Mandie, and congratulations on your upcoming new baby!

Fibrocystic breast tissue is very common; in fact, it's no longer considered a "disease" but just a normal variation. It shouldn't affect breastfeeding itself; however, some women who produce cysts find that their breasts are more tender -- and cutting out (or at least down) on caffeine often helps with that -- whereas other women find that their breasts are actually less lumpy during lactation due to the hormonal changes involved. To learn more about fibrocystic breasts, I recommend "Dr. Susan Love's Breast Book" by Susan Love (your library probably has it).

It is possible, though, depending on how deep the lump was that you had removed and where the incision was made, that the surgery damaged milk ducts on that side, which could cause that side to produce less milk. If so, experimenting with different feeding positions and with ways to increase milk supply, such as breast compression (I'll give you a link in a minute), could be very helpful. Or, because a lot of women find it easier to nurse on one side than the other, and because one side often produces more milk than the other, it could also just be coincidence.

You're wise to be thinking now about how to make breastfeeding work this time around. At this point, I think the best thing you can do is review correct latch-on techniques, feeding positions, and ways to increase milk supply; figure out a breastfeeding support system for when you deliver in case you do encounter problems (for instance, a lactation consultant at your hospital or a La Leche League leader); and expect to be successful. :)

Here are some URLs for information you might find helpful:

Correct latch-on:
www.breastfeedingonline.com/31.html

Breastfeeding After Reduction Surgery -- the pages on "Increasing Milk" (especially "breast compression") can help any nursing mother:
www.bfar.org

To find a La Leche League group in your city or online:
www.lalecheleague.org

Incidentally, I'm puzzled that you were told to stop breastfeeding because of your daughter's reflux. Reflux is another thing that's very common in newborns, and it can run in families, so if your new baby should happen to have this too, please be aware that breastfeeding is still recommended! Things that can help are shorter but more frequent feeds; nursing from just one breast per feeding; holding the baby in an upright position to nurse and then after nursing; in the case of a forceful milk let-down or large supply, pumping for a couple of minutes before putting the baby to breast; cutting dairy out of the mom's diet (reflux is associated with cow-milk allergy). Just something to keep in mind. :)

I hope this helps and that the rest of your pregnancy goes well!

Jennifer