Monday, November 17, 2008

The Effects of Breastfeeding on Breast Esthetics

Updated 3/2017 -- all links (except to my own posts) removed as many no longer active and it was easier than checking each one. 

This is an article review – The Effect of Breastfeeding on Breast Aesthetics by Brian Rinker, MD, Melissa Veneracion, MD, and Catherine Walsh, MD (full reference information below). The full article can be read here (pdf).
It is widely know and accepted that breast milk is good for infants (ie lower risk of many acute and chronic illnesses, transfer of maternal antibodies, etc). Despite this many woman are reluctant to breast feed because of the fear that it will adversely affect the appearance of their breasts.
However, rates of breastfeeding remain low in many industrialized and developing countries. In a 2003 survey, 66% of new mothers reported an intent to breastfeed, and the rate of breastfeeding at 6 months after delivery was 32.8%.6 Despite widespread advocacy, these rates have not changed substantially in more than 20 years. One of the most common reasons cited by women for electing not to breastfeed is the fear that lactation will adversely affect the appearance of the breasts.
Pediatricians and lactation experts have tried to dispute this notion, but it continues to be held by many women.
but is widely held by women and seems to cross both cultural and socioeconomic boundaries
This article is an attempt to look at the issue in an objective manner. They did this by a retrospective study of charts.
Methods: Charts were reviewed of all patients seeking consultation for aesthetic breast surgery between 1998 and 2006. History of pregnancies, breastfeeding, and weight gain were obtained via telephone interview. Degree of breast ptosis was determined from preoperative photos. Nulliparous women were excluded. Logistic regression analysis was performed to identify independent predictors of postpregnancy breast ptosis.
That is the main weakness of the article, but they realize that limitation.
This is a retrospective study with inherent limitations.
The patients were not randomized to breastfeeding and nonbreastfeeding groups, and some differences were observed in the composition of the 2 groups.
A well designed prospective study is needed to further
elucidate the effects of pregnancy, breastfeeding, and
smoking on breast shape. Such a study would follow
healthy women before, during, and after pregnancy, documenting the effects on breast shape and size. The study should follow patients through at least 3 pregnancies, and those in the breastfeeding group would need to have engaged in breastfeeding for at least 3 months. We have begun enrollment for just such a study at our institution.
Even with those limitations, I think their conclusions are sound. It will be interesting to see if the prospective study validates them. Here are the conclusions:
A history of breastfeeding was not found to be associated with a greater degree of breast ptosis in patients presenting for postpregnancy aesthetic breast surgery. Age and cigarette smoking, both of which are associated with a loss of skin elasticity, were found to be positive predictors for breast ptosis, as were larger prepregnancy bra cup size and number of pregnancies. Whereas breast ptosis appears to increase with each additional pregnancy, breastfeeding does not seem to worsen these effects. Expectant mothers should be reassured that breastfeeding does not appear to have an adverse effect upon breast appearance, beyond the effects of pregnancy alone.
The things that a woman can do to help prevent breast ptosis (sagging) are
  • Don’t smoke.
  • Limit the number of pregnancies.
  • Maintain a healthy weight before, during, and after the pregnancy.
The things you can’t change are your age or the fact that genetics gave you DD cup breasts rather than A cup breasts.

The Effect of Breastfeeding on Breast Aesthetics; Aesthetic Surgery Journal, Vol 28, No 5, pp 534-537, 2008; Brian Rinker, MD, Melissa Veneracion, MD, Catherine P Walsh, MD (pdf file)


TBTAM said...

Thanks for this post. So glad someone did a study like this. I have a feeling, though, that the women who won't breastfeed becuase they are worried about their breast appearance, will now just come up with another reason not do it.

emmy said...

The thing that was amazing to me was just how little I knew about breast health until I was diagnosed with breast cancer and read Dr. Susan Loves Breast Book. Until that time, I thought that sagging breast were caused by not wearing a bra. She pointed out in the book that the sagging was actually caused by the loss of tissue density in breasts as we age. She says that there is no medical reason to wear a bra. She also upheald La Leche League's assertion that breast feeding protects women against breast cancer. Imagine the impact of lumpectomy and mastectomy on breast assethics.

ER's Mom said...

So I was right to tell my patients all along that getting knocked up was the problem...

E&R's mom who breastfed both

sober white women said...

My breast are great.... or at least my husband thinks so. I nursed two children, and I even put all of my children in cloth diapers. They lived even when people tried to tell me that they would from wearing cloth diapers.