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.
but is widely held by women and seems to cross both cultural and socioeconomic boundariesThis article is an attempt to look at the issue in an objective manner. They did this by a retrospective study of charts.
That is the main weakness of the article, but they realize that limitation.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.
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: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.
The things that a woman can do to help prevent breast ptosis (sagging) areA 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.
- Don’t smoke.
- Limit the number of pregnancies.
- Maintain a healthy weight before, during, and after the pregnancy.