I’ve known there was something wrong with my breasts since I was 13. They were small and lacked roundness—there was nothing to squeeze together to create the alluring cleavage the other girls my age had. As I went through adolescence without graduating from my AA training bras, I thought longingly of the day pregnancy would finally bring me “real” boobs. But my breasts didn’t grow with pregnancy, and it wasn’t until after my son was born that I discovered they were also deficient in a much more meaningful area: milk production.
My son nursed constantly and always seemed hungry. The paediatrician assured me my milk would come in, but after 24 hours without a wet diaper she conceded that we had to give him formula. I was devastated.
An experienced lactation consultant examined my breasts and did a weighted feed (when the baby is weighed before and after you nurse), and determined I likely had insufficient glandular tissue (IGT). Also known as breast hypoplasia, IGT is a condition in which the breasts lack the glands and ducts that produce milk.
Many new moms worry they’re not making enough milk, but less than two percent of us actually have low milk supply due to biological reasons like IGT, says lactation consultant Catherine Watson Genna. Other causes of low supply include a poor latch or a rough start to nursing that might occur, for example, if the baby is in the NICU for a while after birth. While a lot of times these other difficulties can be overcome, there so far isn’t a way to increase glandular tissue, and moms who do have hypoplasia may not produce enough milk to feed their babies even when both breasts are working at full capacity.
Go ahead, ask me why I’m not breastfeedingLack of breast growth during adolescence and pregnancy is a potential sign of insufficient glandular tissue, as is irregular shaping, and studies have shown that having breasts set widely apart is another indicator. Lactation consultants and other clinicians use a range of colourful vocabulary to describe typical hypoplastic breasts, like “tubular,” “empty sac” and “dog-eared.” Attempting humour, I always described mine as mousy or Snoopy-nosed.
If you suspect you may have IGT, try not to worry too much before the baby is born, says lactation consultant Heather McFadden. She has seen hypoplastic-looking breasts that produced milk, sometimes to a full supply, and “normal” breasts that didn’t. “The truth is I can’t see what’s going on inside,” she says. If the baby starts showing signs of not getting enough milk, however, you shouldn’t delay seeking help from a lactation consultant.
If you do have insufficient glandular tissue, it doesn’t mean you can’t nurse your baby, but breastfeeding may look different than you thought it would. Some women with hypoplasia use a nursing supplementer—a little container of milk connected to a small tube taped to the breast that allows the baby to drink the mother’s breastmilk and the supplemental milk at the same time. It also reduces worries about nipple confusion (in which the baby shows preference for a bottle over the breast) and keeps the baby working hard to keep up milk supply.
“Our culture tends to focus on the milk as a product,” says Watson Genna, “but the relationship is also very important.”
I have to admit, those first weeks of nursing were rough—I’m sure I produced more liquid in tears than milk. But as my baby and I got into a rhythm with our breast and bottle feedings, the whole process began to feel more manageable. By the time he was a toddler, our nursing relationship—one primarily of comfort—didn’t look any different from anyone else’s, and no one would have guessed we’d had such a tough start.