Many women are able to successfully nurse their babies with silicone implants. They are compatible with breastfeeding. I was not sure by your letter whether you had surgery on both breasts, with just an implant on one side. If you only had surgery on the one side, you are at an advantage. If this is the case, you could nurse exclusively from the unaffected side. If you did have surgery on both breasts, the amount of milk you will be able to produce will vary depending on the placement of the implant, whether or not there was significant damage done to the nerves and milk ducts during your surgery -- which is more common if the nipple is repositioned or when there is an incision near the areola -- and the reason for the surgery.

Since a deformity necessitated your surgery, there may be other problems with the nerves and milk ducts aside from any possible damage that might have occurred during surgery. You might want to speak with your surgeon about this.

As far as the possibility of damaging work that has been done, I assume that you are asking if your breasts will sag after nursing. Actually, it is pregnancy and not nursing that causes changes to the breasts.

Silicone is not absorbed from the gastrointestinal tract. It is quite doubtful that nursing with silicone breast implants would be harmful to your baby. Even if silicone did leak from your implants (and the chance of this is only about 1.5 percent), it is highly unlikely that it would be able to leak through the pores in your alveoli (milk-producing cells) and into your milk, due to it's high molecular weight. Also, it's inability to dissolve in water makes it unlikely to enter your milk supply. If it did somehow find its way into your milk, would it be dangerous to your baby? Actually, the silicone used in implants is the same form as in Mylicon drops that have been used for many years to treat gassiness and colic in babies. Silicone is also used in the manufacturing of pacifiers and bottle nipples, in over-the-counter medications, such as antacids, and to coat fruits and vegetables.

The only way to know for sure how much milk you will be able to produce is by nursing your baby. If your baby's output is inadequate, and it is determined that your milk supply is not meeting his nutritional needs, formula can be offered at your breast using a nursing supplementer. Normal output in your baby's first couple of days of life is two to three wet diapers a day, and one to two bowel movements daily. As your milk becomes more plentiful around the third or fourth day of your baby's life, wet diapers begin increasing from about three each day to between six and eight daily, with at least two bowel movements each day.

I would highly advise working along with an IBCLC in your area. She will take a complete history, work with you to position your baby to best access your milk, and will help you to evaluate your milk supply, guiding you in the use of a nursing supplementer if necessary.

It is really important for you to remember that your goal is not necessarily to provide 100 percent of your baby's nutrition at your breast, but to build a loving, nurturing relationship with your new little one. Success is measured in more ways than how much milk you are able to produce. Very best wishes in mothering!

References:

Berlin, C., Silicone breast implants and breastfeeding, Pediatrics 1994 97:547-549.

Dunn, K. et al. Breast implant materials: sense and safety. British Journal of Plastic Surgery 1992; 45:315-321.

Hurst, N. Lactation after augmentation mammoplasty. Obstet Gynecol 1996; 87(1):30-34.

Neifert, M. et al. The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain. Birth 1990; 17:31-18.