| Foreword | xi |
| Acknowledgements | xiii |
| Introduction | xv |
| Diana's Story | xxi |
| Part I | Before Birth: Contemplating Breastfeeding after Breast Reduction Surgery | |
| Chapter 1 | Why Women Have Breast Reduction Surgery | 3 |
| Physical Reasons | 3 |
| Psychological Reasons | 6 |
| Making the Decision to Have Breast Reduction Surgery | 8 |
| Louise's Story | 9 |
| Chapter 2 | Before and After: The Effect of Reduction Surgery on the Anatomy and Physiology of the Breast | 11 |
| Anatomy of the Lactating Breast | 12 |
| Exterior Anatomical Differences of the Breast after Reduction Surgery | 17 |
| Physiology of the Lactating Breast | 19 |
| Effects of Reduction Mammoplasty Surgical Techniques on Lactation | 24 |
| Conclusion | 33 |
| Vicki's Story | 35 |
| Chapter 3 | Why Breastfeeding is Worth the Effort | 37 |
| The Wonders of Human Milk | 38 |
| The Living Biochemistry of Human Milk | 40 |
| The Nutrition of Human Milk | 44 |
| Protection Against Disease | 49 |
| The Functional Benefits of Breastfeeding | 49 |
| The Maternal Benefits of Breastfeeding | 51 |
| A Mother's Pride | 53 |
| Sarah's Story | 58 |
| Chapter 4 | What to Expect | 61 |
| So What Will Your BFAR Experience Be Like? | 61 |
| The Range of BFAR Experiences | 62 |
| Determining Your Lactation Potential | 62 |
| Research Findings | 63 |
| Baseline Lactation Capability | 66 |
| Combinations of Feeding Methods | 70 |
| The Effort and Rewards of BFAR | 73 |
| Patti's Story | 75 |
| Chapter 5 | Preparing to Breastfeed after Breast Reduction Surgery | 79 |
| What You Can Do before the Baby Is Born | 79 |
| Carol's Story | 94 |
| Part II | Baby Is Born: Maximizing Your Milk Supply and Developing Your Breastfeeding Relationship | |
| Chapter 6 | Birth and BFAR Mechanics | 101 |
| Ensuring a Good Start | 102 |
| Beginning to Breastfeed | 104 |
| Establishing Your Milk Supply | 109 |
| The Influence of the Hospital and Health Care Professionals | 116 |
| Tracy's Story | 119 |
| Chapter 7 | The First Month of BFAR | 123 |
| Nurturing Yourself | 123 |
| Tracking Your Baby's Progress | 130 |
| Evaluating Your Baby's Progress to Determine If Supplementation Is Necessary | 139 |
| Special First Month Concerns | 141 |
| Conclusion | 143 |
| Vanessa's Story | 144 |
| Chapter 8 | Supplementing | 147 |
| When to Begin Supplementation | 147 |
| Human Milk Substitutes | 153 |
| How to Supplement | 159 |
| How Much to Supplement | 160 |
| Supplementation Devices | 162 |
| Wendy's Story | 176 |
| Chapter 9 | Increasing Your Milk Supply | 179 |
| Psychological Techniques | 180 |
| Increased Demand Techniques | 182 |
| Galactagogues | 193 |
| Janna's Story | 209 |
| Chapter 10 | Breastfeeding Problems from the BFAR Perspective | 211 |
| Nipple/Areola Problems | 211 |
| Breast Problems | 214 |
| Baby's Problems | 217 |
| Mother's Problems | 227 |
| Overcoming Severe Difficulties | 232 |
| Conclusion | 233 |
| Misha's Story | 235 |
| Part III | Beyond BFAR: Evolving Your BFAR Relationship | |
| Chapter 11 | BFAR and the Older Baby | 239 |
| How BFAR Changes as Your Child Grows Older | 239 |
| Supplementing the Older BFAR Baby | 242 |
| Weaning | 244 |
| Jenifer's Story | 247 |
| Chapter 12 | Emotional Issues | 249 |
| A Wide Range of Emotions | 250 |
| Common Emotional Reactions | 253 |
| Emotional Reactions to Specific Situations | 256 |
| Baby Blues and Postpartum Depression | 259 |
| Coping Techniques | 260 |
| Your Identity As a Breastfeeding Mother | 262 |
| Conclusion | 262 |
| Lara's Story | 264 |
| Chapter 13 | Defining Your Own Success | 267 |
| Exploring Your Feelings | 267 |
| Making Peace with Your BFAR Experience | 268 |
| Defining Your Own Success | 270 |
| Part IV | The Professional Perspective | |
| Chapter 14 | Assisting the BFAR Mother from the Professional Perspective | 275 |
| All Health Care Providers (HCPs) | 275 |
| Plastic Surgeons | 277 |
| Obstetricians and Midwives | 279 |
| Maternity Nurses | 281 |
| Lactation Consultants | 284 |
| LLL Leaders | 285 |
| Pediatricians and Pediatric Nurses | 287 |
| BFAR Topics for Future Research | 290 |
| Appendices | |
| Appendix 1 | Support and Resources | 293 |
| Appendix 2 | Weight Gain Charts | 301 |
| Appendix 3 | Assessment Chart | 305 |
| Appendix 4 | Relaxation Techniques | 307 |
| Appendix 5 | What to Have On Hand Checklist | 315 |
| Appendix 6 | Marmet Technique of Manual Expression | 317 |
| Glossary | 321 |
| Index | 325 |