The Reality of Breastfeeding With Just One Breast
It was near the end of my prenatal hospital class that I decided to ask the question, despite being in a room full of strangers. The instructor had finished a segment on breastfeeding and played a video about latching and positioning. I raised my hand and felt my face get hot. “I’ve had surgery and only have one working breast. Can I still breastfeed successfully?”
After undergoing a bilateral mastectomy and reconstruction in 2018, I’m relieved to have Stage 1 breast cancer behind me. Although my cancer was ER+, I decided not to take Tamoxifen because I knew my husband and I would be trying for a baby the following year. And luckily, to my surprise, I got pregnant quickly.
But I couldn’t help but worry about breastfeeding. I’d heard from friends that supply could be a challenge, especially in the first weeks post-birth. How would I make enough milk if I only had 50% of the equipment? Should I even attempt it?
Back in the classroom, the prenatal instructor answered my question by launching into a story about a woman she knew who had breastfed exclusively after losing a breast to cancer. The day after I delivered my baby, Quentin, two different lactation consultants visited my hospital room and gave me a similar, “It’ll be fine/you can do it” sentiment. I received instructions to start pumping right away — after every feed if I could swing it — and a list of lactation support supplements and foods.
On the second night after Quentin was born, he clocked back-to-back feeding sessions almost all night long. I squeezed every drop of colostrum (known as “pre-milk”) from my left breast, feeling a glimmer of victory through the pain and fatigue.
I continued to feed and pump for the next two days until it was time to visit the clinic for a weigh-in. There, we learned that Quentin had dropped 10% from his birth weight. While this kind of weight loss is considered normal in exclusively breastfed babies, the doctor didn’t want it to continue. She cracked open a bottle of formula, which Quentin proceeded to guzzle. I left the clinic in tears, feeling like I had starved my son, chastising myself for thinking the one-breasted attempt would work.
But things got better after introducing formula. If my son wasn’t satisfied after breastfeeding (which was often the case), I followed up with a bottle. The feeds lasted close to an hour, but I grew accustomed to the order of “breastfeed-diaper change-bottle.” And I was happy that my milk was finally coming in.
I tried my best to pump a couple of times a day to keep my supply up, but soon I was giving formula at almost every feed, to the point that it seemed like a 50/50 split with breastmilk. Whatever the ratio was, it was working — Quentin was gaining weight and sleeping well. My family doctor told me to continue doing what I was doing. But in classic new mom style, I kept worrying.
After too many paranoid Google searches, I found articles on the topic of “combination feeding” — but most of them said to wait until breastfeeding is firmly established before introducing formula, which wasn’t an option for me. Posts on mommy forums talked about giving a bottle of formula a couple of times a day, not after almost every breastfeed.
I needed more reassurance that what I was doing okay, so I called a private lactation consultant, referred by a family friend. She praised my efforts, watched my son feed, and suggested using a supplemental nursing system (SNS), which requires putting a small tube into your baby’s mouth after they latch onto your breast, so they get breastmilk and formula at the same time.
But I knew right away I wouldn’t have the patience to set up the SNS at every feed (or clean the equipment). I resigned myself to the fact that I’d have to keep increasing the amount of formula I gave Quentin as he grew, even if it meant my milk supply dropping.
And that’s where I’m at now. Four months in, Quentin still breastfeeds for 10-15 minutes at the beginning of every feed, burps, then takes a bottle. The number of ounces of formula has crept up steadily as he grows.
I’ve considered taking Domperidone, the drug that can increase your milk supply, but questioned if that’s what’s best for my son, who’s visibly thriving on the feeding pattern we’ve established. I’ve thought about quitting breastfeeding, wondering if it’s worth the effort and stress (and Google searching) for the amount of milk I’m giving him.
But I can’t bring myself to quit — not yet. I’m fortunate to have a baby who latches well, who still wants to breastfeed even though he knows a faster-flowing bottle is on the way. And I’m happy to have reaped the benefits of breastfeeding, especially in the early days — the bonding, the on-the-go convenience, the nutritional support.
That said, I have to question the “breast is best” push in hospitals. Because if you have a physical impairment to breastfeeding, it’s not always reassuring to hear that everything will be fine — sometimes, you just want to hear that your concerns are valid, that it will be challenging, and that you have options if it doesn’t work out.
I never expected to lose a breast to cancer at the age of 34. But I’ve discovered there’s a place to exist between breastfeeding exclusively and not breastfeeding at all — and it’s an area I’m happy to be in. – Erin Letson