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A Unique Beginning

By Roberta Carvalho-Puzon
St. Paul MN USA
From: NEW BEGINNINGS, Vol. 18 No. 1, January-February 2001, pp. 17-18

The first chapter of this story started more than ten years ago, back in my homeland, Brazil. I had breast reduction surgery without even considering the side effects of such a drastic operation. They removed about two and a half pounds of "fat tissue" from each breast. I recovered well, but at the time I was not aware that the surgery cut my milk ducts or that there might have been other surgical options. I was 18 and had given little thought to the possibility of becoming a mother some day in the future. I went on with my life, fulfilling the dream of making a living out of my dance career through teaching, choreographing, and performing.

The second chapter began approximately a year ago, when I found out I was pregnant with Gabriela. During my pregnancy, I made the choice to exclusively breastfeed her. I read extensively, went to a breastfeeding class, and began to realize that a breast reduction could present a problem in terms of milk supply. I also observed a gorgeous breastfeeding relationship between a dancer friend, Wendy, and her daughter, Isabella. She was the first person to tell me about La Leche League. I went to LLL meetings while still pregnant, surfed the web, and talked to friends who were breastfeeding, trying to find out what the chances were of successfully breastfeeding my soon-to-arrive baby. Great advice came from a co-worker, Lisa, who gave advice that would later save my breastfeeding relationship. "Do not hesitate to call our LLL Leader, Rebecca, if you have any questions concerning breastfeeding after you arrive home from the hospital."

We chose a completely natural childbirth. Nevertheless, I had an induced labor, and Gabi arrived on a Thursday evening after 10 hours of labor. After the nurses cleaned her and checked her, they brought her to me. Elbert and I prayed and cried together for such an amazing miracle. She latched on right away and was so alert with her little eyes trying to make sense out of her surroundings. Learning about the possibility of breast reduction surgery affecting my milk supply while I was pregnant was one thing. When I finally had that little creature in my arms, reality hit in a different way. I was very aftaid of not being able to produce enough milk for my baby. I realized the importance of keeping her weight gain under very meticulous scrutiny to find out if she would thrive well on my milk alone. Unfortunately, by her second day it had become necessary to feed her formula. We fed it to her with an eyedropper so she would not experience nipple confusion. I was sobbing by the time I had to leave the hospital on that Saturday afternoon. How was I supposed to care for this new little human being if I could not even produce milk for her?

When I got home, I thought, "I will not be able to feed my child with an eyedropper for very long." I was almost ready to give up breastfeeding. Remembering Lisa's advice, I called Rebecca to explain my case. A very special place in my heart will always be reserved for Rebecca who volunteered to come to my home that same day, bringing me a couple of samples of nursing supplementer devices. The supplementer consisted of a bottle to hold my milk and/or formula, with a tube leading from it. Rebecca showed me how to place the tube next to my nipple so Gabriela would receive the milk in the bottle while she was breastfeeding. That was definitely not the solution I was expecting. But my husband, Elbert, was enthusiastic and supportive of trying new things. He helped me believe it would work. He washed those bottles hundreds of times, often in the middle of the night, and thanks to his support, we kept going.

To this day, I still use the Supplemental Nursing System (SNS) while nursing my girl. Gabriela is now seven months old, she has more than doubled her birth weight, and we have been surviving the stress of being away from each other more than eight hours a day, five days a week, with my fulltime work schedule. I have pumped my breasts regularly to stimulate my milk production ever since she was born. The pumping routine is going very well, and it is fabulous to do something that connects me to my baby even when I am far away from her. Even after all this time I have never produced in a single pumping session more than three ounces of milk from both breasts together. Gabricia drinks an average of eight ounces of milk in a feeding, three times a day. The only reason I was able to breastfeed her is because the supplementer allowed us to feed her in an intelligent, ingenious way.

Some unique conversations have taken place recently. A fellow teacher and I were comparing notes, and I found out his wife also used a nursing supplementer. The second one happened in a store when another woman noticed I was "wearing" my supplementer. She told me that she had also used one when her children were little. I was delighted to know other people in this world knew what a nursing supplementer is and have used one too! The last conversation was with a dancer friend of mine. I was in a theater with Gabriela, getting ready to feed her. My friend asked if I had switched Gabriela to the bottle. I answered, "No, we are still using the SNS." She said she couldn't believe I used the device in public. I replied, "I have no reason to change the way my child is fed in or outside my home. I have no reason to be ashamed of it."

My journey to motherhood has taught me that life does not always happen exactly as you wish, but you do have the power to make your dreams come true if you are willing to dream them differently.

Editor's Note: La Leche League International has published a comprehensive book by Diana West on the topic of breastfeeding after breast reduction surgery called DEFINING YOUR OWN SUCCESS: BREASTFEEDING AFTER BREAST REDUCTION SURGERY (available through the LLLI Online Store). Diana has compiled a wealth of information and advice from health professionals and experienced mothers on breastfeeding after breast reduction surgery. More information on breastfeeding after breast reduction surgery can be found on Diana's website at

Breast surgery will almost certainly impact a mother's capacity to breastfeed at some level. While some mothers who have had breast surgery have produced a full supply of milk for their babies, others are able to provide at least a partial supply of breast milk. Although having breast surgery does not mean that you cannot have a breastfeeding relationship with your child, it probably will present some unique challenges. It is important, then, that mothers who plan to breastfeed after breast surgery obtain the support of a health care professional who is knowledgeable and supportive of the needs and difficulties of this special situation.

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