Hypoplastic Breasts

The term hypoplastic breasts means the same thing as insufficient glandular tissue. This means that you breasts which don't have as many milk producing glands in them as other mothers. It is a rare condition, and is not necessarily associated with how small or large your breasts are.

The image to right was used with permission from 007breasts.com. I personally have 2 friends who have had trouble because of insufficient glandular tissue and that made me look into the condition.

Not all women's breasts with this condition appear the same. Some may be large, some small depending on how many fat cells are also part of that breast.

Are you worried you may have hypoplastic breast tissue? Some signs that indicate you may include:

• A wide space between each breast (no "cleavage")
• Asymmetrically sized breasts (and I thought that was normal for everyone!!)
• Stretch marks on your breast (doesn't seem fair when your breasts are small, I was cranky when they appeared)
• Large areolae (the dark part around your nipple)
• No change in your breast size during pregnancy or immediately after birth

Now you can see that I've commented on some of those indicators and yet I actually don't have insufficient glandular tissue. This is really important for you to note - you can have some of the signs and actually not have this condition.

The image above, taken from the Markers of Lactation Insufficiency paper by Huggins, Petok and Mierles shows the three different types of glandular insufficiency. You may have less glandular tissue present in the lower middle part of the breast, the lower middle and outside of the breast or minimal breast tissue throughout.

To look at that, while not breastfeeding I'd fit into type 2 - those wide pointing breasts that never seemed to develop much in the centre, so you can really see that it doesn't make all that much difference necessarily.

Some girls have huge breasts but it's all fat too. This means they expect things to go somewhat smoothly with breastfeeding, but actually don't produce enough milk.

Even if you do have low supply but are given good help and support in the first month after birth, you can sometimes overcome the low milk supply too.

Some women with hypoplastic breast tissue do find that even with good support though, they are unable to create enough milk for their babies and may need to supplement their milk. You can supplement with either donor human milk or formula. There has been a great swing towards donor milk banks in the last few years and human milk is becoming easier to obtain.

The other great news is that with subsequent pregnancies you will find that your breasts will be stimulated more each time and will produce more milk. A friend of mine who had a hard time with her first baby and had to supplement, has had a really easy time with making enough milk for her second baby.

This shows through in studies too, but for those of you who have really low supply, research shows you can also look into progesterone supplementation as an alternative during your pregnancy to help stimulate the growth of the milk developing cells.

How Do I Know If I Need To Supplement My Breast Milk?

What Are the Different Ways of Using Supplemental Milk?

What Else Can I Do To Increase My Milk Supply?

What Causes Insufficient Glandular Tissue?

Other useful pictures to look at come from plastic surgery sites, as this is a common condition to make women consider augmentation. The next two pictures show the before and after photos.

How Do I Know If I Need To
Supplement My Breast Milk?

Some signs that your baby is not getting enough milk include:

• Less than 6 heavily wet disposable or 8 heavily wet reusable diapers each day
• No bowel motions within a week of the last meconium
• A continued weight loss after your milk comes in or a failure to gain weight in line with the percentile on which they are tracking

Do not be worried by your baby being in a low percentile. This graph of percentiles takes in the whole population and there is always going to be some smaller and some bigger babies. It is more important that your baby stays within a small range of the percentile they are on. A baby dropping from 90th to the 80th percentile in a few weeks needs following up but one who stays on the 15th percentile for all readings is not of concern.

What Are the Different Ways of
Using Supplemental Milk?

There are five options you could choose to use when supplementing milk for your newborn.

• Supplemental Nursing System
• Spoon Feeding
• Cup Feeding
• Syringe Feeding
• Bottle Feeding

A supplemental nursing system can be used with either formula or donor milk and means your baby is still getting their feed at your breast. For mothers with hypoplastic breast tissue it also means your baby is stimulating your breast to make more milk.
You will have a bottle which is sitting above the height of your baby. Your baby will attach on as normal but will have a supply line from the bottle which comes in at the side of their mouth. This means you can enjoy breastfeeding longer or more frequently than your milk supply allows and gives you the opportunity to produce the maximum amount of milk you are capable of. For more information about sat breast supplementation see the Low Milk Supply Organisations At-Breast Supplementation article.
If you use any of the other methods your baby should be sitting upright and given the milk slowly this includes for bottle feeding. Lying a baby down while bottle feeding gives them milk very quickly which can cause gagging or choking to occur. You will be surprised how quickly your baby gains the coordination to drink with a spoon or cup.
Bottle feeding needs to be used cautiously by women with hypoplastic breasts who wish to continue breastfeeding. A bottle is very easy to get milk from and can cause your baby to become fussy at the breast. There are some excellent teats available for the Medela range of bottles which will not give milk unless your baby sucks which helps them to not refuse the breast.

What Else Can I Do To Increase My Milk Supply?

To help mothers with hypoplastic breasts and insufficient glandural tissue to make as much milk as they are capable of, there are herbs called galactogogues which can help your body to produce more milk, and some medications can also help you to produce more milk. See your lactation consultant or doctor for advice about these.

Other things you can do include:
Offer your breast on demand - Breastfeeding more frequently helps you make more milk. This can be very frequent breastfeeding schedule , and many mothers with hypoplastic breast tissue find themselves breastfeeding hourly and sometimes more frequently, particularly in the afternoon.

It might be really stressful (and you are wise to ask for lots of help) but do not worry that you are spending your whole time breastfeeding - what better gift could you give your child than your attention and breast milk. Your housework will still be there tomorrow and the next day! If you want to do it, and it feelsright to go this way then surrender to the process and know that everything will work out and all the effort you've put in will be worthwhile.

Some old fashioned sayings also talk about spoiling your child by holding them so much. This is very outdated thinking and you needn't worry. Research shows that babies who feel their parents, particularly their mother, is in tune with what they need grow up to be less stressed as teenagers and adults and more engaged in their community.

Use a breast pump for five to ten minutes at some point between each breastfeed - your breast tissue makes more milk when it is removed. By breastfeeding and pumping you are increasing the amount your body is capable of producing. The pumped milk can be used as a supplement at the next feed. Even just pumping until you have a let down (and definitely not worrying about how much is coming out, you are just aiming to stimulate)

Eat plenty of quality food - at least three main meals and two snacks a day. Getting plenty of protein and a good amount of fat with your carbohydrates is important. Protein and fat help to stabilise your blood sugar level and this will help you to produce more milk and improve your hormone balance. Part of what causes this condition in the first place is a lack of progesterone and your ovaries are sensitive to insulin, making less progesterone if there are higher insulin levels. Insulin is released in higher levels if you have more carb containing meal, so keeping you blood sugar under control with more protein will help in the future too (and can help with fertility and period pain too as a an added bonus!). Click here for healthy diet choices for breastfeeding mothers.

Drink plenty of water - at least eight glasses, but preferably more. Being dehydrated will mean you have less milk volume. You should be needing to pass urine at least every three hours. If you aren't, try increasing your fluid intake.

Get as much sleep as you need - sleeping when your baby sleeps really helps you to produce more milk. Again, your housework will still be there tomorrow or the next day. i found personally that my little guy didn't sleep well unless he was on me in those early months so I'd lie down with him on me and have a well earned rest!

What Causes Hypoplastic Breast Tissue?

Hypoplastic breasts and insufficient glandular tissue are caused by low oestrogen and progesterone levels (your feminine hormones). Some other problems associated with hypoplastic breast tissue include:

• Polycystic Ovarian Syndrome
• Luteal Phase Defect
• Endometriosis
• Infertility

There is a growing number of parents who have used infertility treatments such as IVF and stimulation of the ovaries during ovulation which means there is also a growing number of women finding they have a low milk supply.
Good support from family and friends is essential to help you get through this time with the least amount of stress.

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