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Breastfeeding with Insufficient Glandular Tissue
It can be frustrating for some and devastating for others when breastfeeding doesn’t go as planned. In trying to provide better support and education to new mothers, many breastfeeding advocates understandably focus on the goal of success, especially with a healthy baby who appears to be breastfeeding well. After all, most barriers to breastfeeding is temporary and short. For a small minority of women, however, there are obstacles that no amount of time or effort can overcome.
Insufficient glandular tissue, or IGT, is a rarely discussed condition in which a mother has underdeveloped glands that are therefore less able to produce milk. While many women with this condition also have small breasts, it is important to note that breast size alone is not an indication of IGT and that most women with small breasts produce enough milk. In contrast, IGT is marked more by breast hypoplasia (asymmetry or underdevelopment that can be assessed by a doctor), and many women later diagnosed with IGT report little or no breast change during pregnancy and lactation. Photographic documentation of breast hypoplasia often shows visually obvious underdevelopment in one or both breasts, but variations in breast shape can vary dramatically from woman to woman, and the condition is not always visually obvious.
The good news is most women with IGT can breastfeed successfully, although in most cases supplementation is required. Some women experience only delayed lactation and with adequate stimulation and temporary supplementation can later resume exclusive breastfeeding. In some extremely rare cases, a mother must use formula exclusively.
Here are some tips if you suspect you may have IGT:
The If you are still pregnant, prepare yourself emotionally and tell your doctor about your concerns. One of the biggest difficulties for women with IGT is the frustration they experience during the postpartum rush of emotions. Many women experience feelings of anger, guilt or inadequacy, especially with the lack of information about IGT. The more you can prepare, the better off you are.
The If your baby has already been born – don’t panic. Remember that most breastfeeding problems, even those related to poor weight gain, can be resolved and are not actually IGT. Contact a lactation consultant to assess your chances and get advice on how to maximize your milk production potential.
The Keep a detailed feeding and nappy diary. This information will be valuable to you and your child’s caregivers in assessing when and if supplementation is needed.
The Always stay in touch with your child’s pediatrician.
The Discuss your concerns about having IGT with your OB-GYN and/or lactation consultant. Many women diagnosed with IGT report that no one discussed the issue with them prenatally.
The If you’ve been advised to supplement with formula, feel free to do so. While formula is second best to breast milk, it is a nutritious alternative on which babies not only survive, but thrive.
The Most babies can adjust to both breast and bottle feeding, especially after the first few weeks. If you’re concerned about nipple confusion in a newborn, there are many ways to supplement besides a bottle, including a dropper or SNS (supplementary nursing system.)
The If you wish to continue breastfeeding, remember to always breastfeed first and thoroughly before giving your baby a complementary bottle. Some doctors may also advise using a hospital-grade electric pump to pump after each feeding to ensure the breasts are fully drained. As long as breastfeeding sessions are as frequent and thorough as a woman without IGT, you will maximize milk production.
Finally, if you have IGT, keep calm and move on. Whatever you decide, it’s important for a mother to feel confident and positive about her circumstances and feeding choices. Many mothers with IGT go on to have successful and satisfying breastfeeding relationships. However, breastfeeding with IGT has its own challenges as you cannot enjoy the full benefits of breastfeeding the bottle feeding and there can be a range of physical and emotional tolls that only you can assess. If you feel that supplementing is too impractical for your circumstances and choose to exclusively bottle feed, do so free of any feelings of inadequacy or guilt. As a whole woman and a whole family with different circumstances and needs, only you can decide on a practical feeding plan for your baby that not only nourishes your child, but creates a family situation that is calm, balanced and satisfied. Your baby’s greatest need isn’t just breast milk, it’s you.
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