The ABC’s of Breastfeeding: Insufficient Glandular Tissue
We wouldn't be having an honest discussion of breastfeeding if we didn't also include the fact that sometimes it doesn't work. There are rare cases where babies cannot nurse (like my tube fed first born, who aspirated on everything because of muscle weaknesses) and there are cases where a woman's body simply does not produce sufficient milk. One of the most common reasons for this (although it's still rare) is IGT: insufficient glandular tissue, or breast hypoplasia.
IGT is not diagnosed based on breast shape; many women with small breasts are able to produce fabulously well. The diagnosis criteria for IGT revolves more around breast shape and structure, because it has to do with the breast's failure to develop glands during adolescence. It also should not be self diagnosed, as there are often so many other factors that can make breastfeeding complicated in the early days. If you think it's a possibility, it's imperative to make an appointment with a specialist and ask them for their evaluation. Contact an IBCLC in your area or another medical provider specializing in women's health. If you also fail to notice any change in your breasts during pregnancy, this can be a sign that further investigation might be warranted.
If you do have IGT:
** remain confident in the fact that this doesn't change your precious value as a mother or change your wonderful bond with your baby. Sometimes mothers are concerned that not breastfeeding means they won't bond well with their baby; this is not true. Snuggle your baby, sing to your baby, and know that you still 100% rock their world!
** Explore Your Options With Confidence That You Know Best For You & Your Baby. Some mothers with IGT use a supplemental nursing system; some use donor milk in bottles; some nurse and round off with formula; some use exclusively use formula. Reach out for support ~ to other mothers with IGT, to your doula, your family, other support... and then check in with yourself. You know what is best for you and your baby; make your choice with confidence!
** Also Know That Things Can Change. You'll never post pictures of crazy big freezer milk stashes that other women do. And that's okay. But it is a fact that your body creates more glands each pregnancy/each breastfeeding experience. Breastfeeding has amazing health benefits for you as a mom (lowers risks of some cancers & diabetes, for starters!) and if it's something you passionately wanted to do, be encouraged in the knowledge that what you experienced your first time is not necessarily what you will always face.
If you have a friend who is diagnosed with IGT: ask how they are doing and really listen for the answer. Maybe they're at peace with it and really would just like to coo over the new baby dimples. Maybe there's some grieving going on and they need support (and maybe a fresh meal and flowers!).
Please do not tell them about your second cousin's best friend who struggled with low supply and fixed it all with these miraculous supplements. IGT is a real, medical condition and doesn't need armchair medical care. If you have experience with IGT or know people who do, offer that knowledge, but really just be there to support your friend in whatever your friend needs.
~~ Other resources on this topic:
Australian Breastfeeding Association's IGT Page
KellyMom (always an excellent source!) A Personal Account of Struggling with IGT