Milk Supply After Breast or Nipple Surgery

Although ducts may have been severed during the surgery, ducts can reconnect and/or grow back over time (recanalize). This happens at an accelerated rate during pregnancy and lactation, so having been pregnant after the surgery may have prompted least some ducts to grow back, and the longer you’re able to lactate, the more chance ducts have to recanalize.

Most of the milk released during breastfeeding and pumping happens during the “milk ejection reflex,” also known as “letdown.” This process happens when nerves in your nipples and breasts are stimulated by the baby or pump. It can also happen spontaneously just by thinking about breastfeeding or your baby (and sometimes even the pump!).

Since the milk ejection reflex is so important to how much milk can be expressed, the condition of your nerves after the surgery plays a critical role in your milk-making ability. When they’re not working well, it can be harder to express the milk.

The amount of sensitivity in your nipple is a good indicator for how much the nerves affecting milk ejection have healed. During the healing process, they may become more sensitive than normal, but over time the sensitivity should return to the way they were before the surgery.

When there isn’t full sensitivity, there are several ways to stimulate milk release, including certain herbs, breast compressions, and psychological conditioning. 

There’s no way to know how much milk you’ll have or how well your milk ejection reflex (letdown) is working until around the fourth day after the baby is born when the colostrum milk transitions to mature milk with a rapid increase in volume. This process is known as the milk “coming in” or “engorgement”. (Births by c-section tend to delay this process by an extra day or two.)  

When the surgery was at least five years before the baby’s born, most people make a significant amount of milk, even though they may not have a full milk supply, since milk-making capability depends on the amount of connected ducts and nerves that affect lactation.

The glands connected to the ducts that were severed during the surgery will produce milk initially, but if some ducts are severed (cut), the milk won’t be able to get out through the nipple. Over about ten days, they’ll gradually stop making milk and atrophy (go back to their pre-pregnant state). This can cause a longer period of engorgement. (See this page for good strategies for managing engorgement.)

If the milk supply isn’t enough after engorgement has resolved, there are many effect strategies for increasing the milk supply.

You don’t have to have a full milk supply to have a fulfilling breastfeeding experience!

There are many ways to supplement with donated milk or formula that support breastfeeding.

And breastfeeding is far more than food for your baby. It has wonderful advantages for both you and your baby, in ways science is always discovering.

For many people, the positive emotional effects of breastfeeding are even more powerful than the nutritional components. This 2018 research study showed increases in children’s brain, cognitive, and socio-emotional development. It also showed positive effects on parents’ mood, emotions, stress, and nurturing abilities.