When Breastfeeding Doesn’t Work…Part 4: Breast Hypoplasia

This is the fourth post in a series about breastfeeding and my very personal experience with it. If you haven’t read previous posts, it might help to start with Part 1.

In the years that followed, many of my friends went through their first pregnancies and I was able to see first-hand the many changes they experienced–which were very different from what had occurred during Big Brother’s pregnancy. It furthered my gut feeling that something was “wrong” with my body. And, the feelings of guilt, shame, inadequacy, even jealousy, often resurfaced. As happy as I was for friends who were successfully producing abundances of milk and happily nursing their babies, it was a constant reminder of what my body had failed to do.  But, everyone I spoke to (including doctors, nurses, etc.) would remind me that every pregnancy is different, so there is the real possibility that things would be different better the second time around.

Then, in the summer of 2009, the “second time around came”. We happily found out that I was pregnant again (with a due date of Big Brother’s 3rd birthday)!! I was desperately hoping that all the typical breast change signs would start happening. But, they didn’t. As the months went by and there were no changes once again, I begin doing research–lots of research! In my quest, I discovered a condition relating to insufficient glandular tissue (IGT) called Breast Hypoplasia (also known as Mammary Hypoplasia).
Some common features include (which can vary in severity):

  • breasts with an “empty sac” appearance (lack of normal fullness especially on the underneath rounded part of breasts where many lactiferous ducts/lobules are found)-can lead to a tubular shaped appearance
  • asymmetry (two different sized breasts-often pronounced)
  • wide space between breasts
  • overly large areolae relative to breast size
  • no change in breast size during pregnancy
  • no engorgement or fullness in the typical time period after birth

It was a stunning discovery. To varying degrees, I have almost every characteristic. On the one hand, it was a relief to finally have confirmation that there was a real cause for the problem breastfeeding. The issues I had with my appearance and now breastfeeding failure were caused by an actual, scientifically-noted “problem”. Yet, of course, another part of me was devastated again at the realization that something was in fact “wrong” with my body and, the confirmation that I would likely never be able to produce enough milk to exclusively feed my children. In addition, I was frustrated and angry. Why had all the books and literature I come across barely even mentioned that such issues even exist, let alone described anything about them?  Even worse, why had none of the doctors, nurses, or lactation consultants mentioned this condition when it was clear that things weren’t functioning normally?

There is medical literature out there. There is a lot of information in this article detailing markers of lactation issues and this article from the National Institutes of Health even states that “Preserving the ‘every woman can nurse’ myth contributes to perpetuating a simplistic view of lactation and does a disservice to the small percentage of women with primary causes of unsuccessful lactation.”
And, La Leche League International has a whole article to educate their lactation consultants on Mammary Hypoplasia: “In our quest to support breastfeeding mothers and their babies, we encounter few cases more tragic than those in which the mother prepares and plans to breastfeed her baby, practices optimal breastfeeding management, and has lots of support in the early postpartum days — but never makes enough milk for her baby to thrive. Often, the mother is told by her baby’s pediatrician that she needs to feed the baby artificially at once or risk serious trouble, and no one explores her milk shortage because the health care providers are focused on ensuring that the baby’s nutritional status is adequate. The mother’s self-esteem might suffer if she feels that her body “failed” her, and she may feel cheated of the breastfeeding relationship and nurturing she dreamed of sharing with her new baby. Worse, she may never get any answers as to why she was unable to provide enough milk for her baby. As time passes, she may wonder whether she should even attempt to breastfeed any other babies she might have.” This sums up my experience almost exactly! Yet, they go on to say, “We may struggle with how, or even whether, to tell a mother that breastfeeding may be difficult for her or may take some extra work to get established.” Please tell mothers!!  Otherwise, all this does is perpetuate the “every woman can nurse” myth! How I wish someone would have recognized the signs and been HONEST with me!! I am certain the emotional anguish I experienced after Big Brother’s birth would have been much less and the overall experience would have been much more successful!

Knowledge is power and with this knowledge, I was able to to not only logistically, but emotionally plan for trying to breastfeed Little Brother. The goal was to correct some of the breastfeeding mistakes that were made with Big Brother in an effort to produce more milk. We rented a hospital grade pump to start using fairly soon after birth; the herbal supplements and teas were purchased to start taking sooner; a better supplemental nursing system was purchased. After Little Brother’s birth, it was immediately evident that he was a better nurser. He was easier to latch, was more interested in nursing, and nursed longer. Due to his size though, there was some concern about his blood sugars and I was very concerned about going through the starving screaming issues & jaundice again, so we did some small supplementing in the hospital. Yet, I was also adamant about seeing lactation consultants and thoroughly discussing the IGT issue with them.
One was very good and explained that we were doing everything possible–to just go with it as we had planned and hope that we see an increase in supply as compared to Big Brother. I was cautiously hopeful…

(Join us for the final installment tomorrow)
Whole series: 
Part 1
Part 2  
Part 3 
Part 4 
Part 5

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