The impact of breast reduction surgery on breastfeeding: Systematic review of observational studies

Abstract

BackgroundAlmost half a million breast reduction surgeries are performed internationally each year, yet it is unclear how this type of surgery impacts breastfeeding. This is particularly important given the benefits of breastfeeding.ObjectivesTo determine if breast reduction surgery impacts breastfeeding success and whether different surgical techniques differentially impact breast feeding success.MethodsDatabases were searched up to September 5, 2017. Studies were included if they reported the number of women successful at breastfeeding or lactation after breast reduction surgery, and if they reported either the total number of women who had children following breast reduction surgery, or the total number of women who attempted to breastfeed following surgery.ResultsOf 1,212 studies, 51 studies met the inclusion criteria; they were located worldwide and had 31 distinct breast reduction techniques. The percentage of breastfeeding success among studies was highly variable. However, when analyzed by the preservation of the column of parenchyma from the nipple areola complex to the chest wall (subareolar parenchyma), a clear pattern emerged. The median breastfeeding success was 4% (interquartile range (IQR) 0–38%) for techniques with no preservation, compared to 75% (IQR 37–100%) for techniques with partial preservation and 100% (IQR 75–100%) for techniques with full preservation.ConclusionsTechniques that preserve the column of subareolar parenchyma appear to have a greater likelihood of successful breastfeeding. The preservation of the column of subareolar parenchyma should be disclosed to women prior to surgery. Guidelines on the best breast reduction techniques to be used in women of child bearing years may be advantageous to ensure women have the greatest potential for successful breastfeeding after breast reduction surgery.

Experiência de amamentação de mulheres após mamoplastia

“…The decision-making of these women was limited, in which most of them disregarded the effects of mammoplasty on breastfeeding, facing doubts and/or questions only years after the surgery when they became pregnant (1,21) . In the conceptual framework of the theory, organizational systems of protection, promotion and support are related to other previously discussed elements, emerging as compensation resources to deal with the constraints arising from inadequate biological conditions for breastfeeding (9) .…”

A Scoping Review on the Attributes of Cluster Randomized Controlled Trials in Long-Term Care Facilities

“…e Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines were used [5]. In addition, the methods followed in this review were similar to the methods in Kraut et al 2017 systematic review [6].…”

Contraindications to Breastfeeding - Current Issues at the Border Between Myth and Reality

“…When performing the procedure, certain surgical techniques are used to maintain breastfeeding capacity. It seems that preserving the subarachnoid parenchyma increases the subsequent chances of breastfeeding, when the subarachnoid parenchyma was not kept, only 4% of women were able to breastfeed 35 . Some studies have shown that women following reduction mammoplasty discontinued exclusive breastfeeding after an average duration of only 5 days and had an exclusively breastfeeding rate at 4 months after birth of 4% compared to control 22% 36 .…”