Occasionally, nursing mothers can experience severely lopsided or uneven breasts while breastfeeding. Let me clarify to start that what I mean to describe is not slight differences in size between breasts – just as with non-nursing breasts, it is normal for one breast to be slightly larger than the other, and that difference can become exaggerated with the increase in size during nursing. What I mean is drastic size differences which generally go along with drastically different capacities for milk supply between the two breasts.
It's not always clear why lopsided breasts occur. I personally have known several women who have experienced this phenomenon, some of whom continued nursing with uneven breasts for many months or even years. I always assumed that it was caused by early lack of attention to establishing milk supply by switching breasts or remembering to start on alternating sides carefully enough. When it does occur, I have heard lactation consultants explain that it not particularly necessary to correct this problem -- that babies can nurse successfully and for a long time on uneven breasts – that it is mainly a cosmetic and convenience issue and would not continue after weaning.
However, I experienced this phenomenon myself about two weeks after the birth of my second daughter. I *was* nursing on-cue, switching sides each feeding and having successful feeds on both sides. But all of a sudden, I awoke one morning to find that one side had seriously dropped production and the other side apparently was making up the difference. The unevenness worsened as over the course of the day…by bedtime, I looked like a one-woman before-and-after photo for breast enlargement surgery!
The baby was nursing fine and continuing to have wet diapers and regular bowel movements, so I knew that overall supply was not a concern. I remembered what the lactation consultants had said about just accepting it and nursing on, but being only two weeks into what I hoped would be at least two years of nursing, I simply wasn't willing to just consign myself to years of visibly uneven breasts.
By actively managing and increasing the supply on the smaller breast, and then decreasing the supply on the larger breast, I was able to return both breasts to normal production. For the details on how I safely managed this process (note that the most important part of any sort of milk supply management is ensuring the continued nutrition and hydration of the baby), see my article on "Correcting Lopsided Breasts While Breastfeeding."
For most women, I believe that lopsided or uneven breasts need not be a permanent condition if dealt with quickly to manage supply. First and foremost, care must be taken to maintain proper nutrition for the baby. But within that guideline, based on my own experience, I believe that with patience and commitment this problem can usually be corrected.
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