We’ve all heard the encouragement passed on to breastfeeding mothers: “Almost any mother can breastfeed if she tries hard enough.” “It’s just supply and demand! Nurse more often and you’ll make more milk!” “Just relax! Women have been doing this since the beginning of time.”
For most women, the solution really is as simple as nursing more often, improving the baby’s latch or taking a few herbal supplements. But for that tiny percentage of women who put the “almost” in “almost any mother,” those steps aren’t enough.
If that sounds familiar, your heart is probably breaking as you try everything your pediatrician, lactation consultant and breastfeeding books recommend only to watch as your baby keeps losing weight.
It’s hard not to wonder what you’re doing wrong.
Here’s the thing, though: There’s a chance you’re not doing anything wrong! A small but significant number of mothers, La Leche League International estimates 1 in 1,000, have a condition called Mammary Hypoplasia or insufficient glandular tissue (IGT). If you have IGT, your breasts simply don’t have as many milk-producing glands as they’re supposed to, making it as impossible for you to make enough milk as it is for a diabetic to make enough insulin.
There are a few telltale physical markers that women with IGT tend to have.
Unusual Breast Shape
The clearest sign of potential IGT is an unusual breast shape, a tubular shape that makes your breasts look a bit like an empty sack or a sock with a tennis ball at the tip. Most of your milk-producing glands are at the base of the breast, so if you have hypoplasia, those bases will be underdeveloped.
Alternatively, your breast might look fine from above but have very little tissue underneath the nipple; you might feel as though one or both of your breasts never fully developed during adolescence.
Breast size in and of itself has nothing to do with IGT; a woman with an A cup and full, rounded breasts is probably fine, while a woman with a D cup and tubular breasts might have IGT.
It’s normal for women to have one breast that’s slightly larger than the other but women with hypoplasia often have a noticeable difference in breast sizes.
If your breasts are asymmetrical to the point where you wear two different cup sizes, you might have IGT; 61 percent of the IGT moms in the study did.
Most women have a space of about an inch between their breasts. Try measuring the space between the bases of your breasts. If it’s 1 1/2 inches or more, that’s another marker for likely hypoplasia.
Remember, the bases of your breasts have the milk-producing tissue. If you have more space, it’s because some of that tissue is missing.
Little Growth, Little Engorgement
Your pregnancy books and websites undoubtedly mentioned that your breasts were going to grow significantly larger during pregnancy. If that never happened to you, you may have IGT, because it’s a sign that the milk-producing glands never expanded and filled as they were supposed to.
Similarly, most women start feeling engorged if they go too long without nursing, particularly after their milk comes in. If you don’t, it may be because you aren’t making enough milk to get that engorged feeling.
What To Do
If you have one or two of these signs, there’s no need to panic, especially if taking typical steps seems to be helping your milk to come in. Plenty of mothers have oddly shaped or asymmetrical breasts and a perfectly normal milk supply. However, if you have several of these signs and nothing seems to be helping, you may have hypoplasia.
It’s important to find a lactation consultant or doctor who has experience with mothers who have chronic low milk supply. These caring professionals will be able to give you a formal diagnosis and will not act as though your low milk supply is somehow your fault.
They will also be able to help you come up with a plan that lets you breastfeed your baby while still giving him the nourishment he needs.
A support group is tremendously important in this time as well. If you have IGT, you may feel as though your dreams and plans about breastfeeding have fallen apart, or as though your body has failed you.
The constant “breast is best” mantra may make it seem as though you’re hurting your baby by supplementing with formula. Well-meaning people might invalidate your grief by giving you guilt trips because “at least your baby is healthy.”
Finding women with similar problems can help you mourn and make peace.