BREAST IMPLANTS MAY HAMPER BREAST-FEEDING.

Byline: Theresa Tamkins Medical Tribune News Service

Women with breast implants may have trouble breast-feeding their infants, according to a new report.

In a study of 84 new mothers at a Texas hospital, 64 percent of those with breast implants had problems producing enough milk to feed their infants, while only 7 percent of women without implants had such problems.

Among women with implants, the type of surgery they had also predicted whether they had problems with breast-feeding: women who had an incision made around their nipple were more likely to have problems producing milk than women who had an incision in the armpit or below the breast, according to the study, published in the January issue of the journal Obstetrics & Gynecology.

Breast surgery most likely disrupts the nerves that are important for successful breast-feeding, according to study author Nancy Hurst, director of the lactation program and the human milk bank at Texas Children's Hospital in Houston.

"Normally when the baby begins to suckle, it triggers those nerves to trigger hormones to release milk," she said. If the nerves are severed, the volume of milk to the child may be reduced, according to the Texas nurse.

An incision around the nipple, which is done to help make the scar less noticeable, also may sever ducts that drain milk from the mammary gland, according to Dr. Marianne Neifert, a medical consultant to the lactation program at Presbyterian/St. Luke's Medical Center in Denver.

So even if the mother has an adequate milk supply, it may be difficult for the milk to drain into the nipple, Neifert said. Eventually, that area of the breast will shut down and stop producing milk, she added.

"I was delighted to see this study," Neifert said. After working with a breast-feeding clinic for more than a decade, Neifert said she suspected that breast-implant surgery could affect a woman's ability to breast-feed.

"But almost all of the mothers who had the surgery would say this wasn't something they were warned about," the Colorado expert said.

According to Dr. John William Little, president of the Plastic Surgery Education Foundation at the American Society of Plastic and Reconstructive Surgeons, the new study does not prove that implant surgery interferes with breast-feeding.

The report did not take into account women's breast size before surgery, and breast size can affect a woman's ability to lactate, he said.

"Most women seeking implants don't come in with adequate B or C breasts," he said. "Most come in because they feel somewhat deformed by the lack of adequate breasts."

It may have been something about the women's smaller breasts that caused breast-feeding problems - not the implant surgery, Little said.

One surgical technique, in which an incision is made around the nipple and breast tissue is cut to place the implant, may interfere with breast-feeding, Little acknowledged. But that technique is no longer commonly used, he said. Instead of cutting the breast tissue, surgeons now maneuver around it, according to Little, a clinical professor of surgery at Georgetown University Medical Center in Washington, D.C.

"I think the average plastic surgeon has not been aware" of breast-feeding problems associated with implant surgery, he said. "If it is, in fact, a problem, a patient needs to be told. But we can't conclude it is a problem from the basis of this study."