Breastfeeding Counseling Practices Among Plastic Surgeons: Results From a National Survey

Breastfeeding has well-established benefits for maternal and infant health. Difficulty with breastfeeding is a possible complication after breast surgery and can have detrimental maternal psychological consequences. Although lactation outcomes after breast surgery have been reported, plastic surgeons' preoperative counseling practices regarding breastfeeding after surgery have not yet been studied.

From November 2021 to January 2022, a 25-question anonymous survey on breastfeeding counseling practices, personal breastfeeding experiences, demographics, surgical training, and length of practice was administered to 6000 members of the American Society of Plastic Surgeons.

A total of 146 respondents were included, and 90.7% of respondents believe that breast surgery can affect breastfeeding. Although 96.6% of respondents routinely discuss possible postoperative challenges with breastfeeding, 39.3% differentiate between inclusive and exclusive breastfeeding, 22.2% discuss potential emotional consequences, and only 12.8% discuss the need for galactagogues or labor-intensive ancillary activities. Significantly more respondents who had been in practice for less than 15 years believed that breast surgery can affect breastfeeding and reported counseling on breastfeeding impairment risk before transgender top surgery, compared with those who had been out of training for more than 15 years (96% versus 84%, P = 0.05; 72% versus 54%, P = 0.05).

Most plastic surgeons believe breast surgery can affect lactation and counsel patients as such. However, the potential deleterious mental health consequences of challenged breastfeeding after breast surgery seem undercounseled. Our findings highlight a potential need for increased education and improved preoperative breastfeeding counseling protocols for plastic surgeons.