Breastfeeding with insufficient glandular tissue
It can be frustrating for some and devastating for others when breastfeeding doesn’t go as planned. In their quest 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 nursing well. After all, most obstacles to breastfeeding are temporary and short. For a 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 the mother has underdeveloped glands that are thus 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. Rather, IGT is mostly noticed by breast hypoplasia (asymmetry or underdevelopment that can be assessed by a doctor), and many women diagnosed with IGT later report little or no breast change during pregnancy and breastfeeding. The photographic record documenting breast hypoplasia often shows a visually obvious underdevelopment of 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 that most women have IGT i can successfully breastfeeds, although in most cases supplementation is necessary. Some women experience only delayed lactation and with sufficient stimulation and temporary supplementation may later continue to breastfeed exclusively. In a few extremely rare cases, a mother with HIV must use formula exclusively.
Here are some tips if you suspect you may have IGT:
Fr If you are still pregnant, prepare yourself emotionally and let your doctor know about your concerns. One of the biggest difficulties for women with IGT is the frustration experienced during the postpartum rush of emotions. Many women experience feelings of anger, guilt, or inadequacy, especially because of the lack of information about IGT. The more you can prepare, the better off you are.
Fr If your baby is already born – don’t panic. Remember that most breastfeeding problems, even those associated with poor weight gain, can be resolved and are not actually IGT. Contact a lactation consultant to assess your options and get advice on how to maximize your milk production potential.
Fr Keep a detailed feeding and diaper diary. This information will be valuable to you and your child’s caregivers in determining when and if a supplement is needed.
Fr Always keep in touch with your child’s pediatrician.
Fr Discuss your concerns about possible IGT with your OB-GYN and/or lactation consultant. Many women who are diagnosed with IGT report that no one discussed the problem with them before giving birth.
Fr If advised to supplement with formula, do so with confidence. While formula is second best to breast milk, it is a nutritional alternative that babies not only survive on, but thrive on.
Fr Most babies can adapt to both breast and bottle feeding, especially after the first few weeks. If you’re worried about nipple confusion in a newborn, there are many ways to supplement besides the bottle, including a dropper or SNS (supplemental nursing system).
Fr If you want to continue breastfeeding, remember to always breastfeed first and diligently before giving your baby an extra bottle. Some doctors may also advise using a hospital-grade electric pump to pump after each feeding to ensure the breasts are fully pumped. 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 is important that the mother feels confident and positive about her circumstances and her feeding choices. Many mothers with IGT go on to have successful and fulfilling breastfeeding relationships. However, breastfeeding with IGT has its challenges as you cannot enjoy the full benefits of breastfeeding. or bottle feeding and there can be a range of physical and emotional burdens that only you can assess. If you feel that supplementing is too impractical for your circumstances and choose to bottle feed exclusively, 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 plan for feeding your baby that not only feeds your child, but creates a family situation that is calm, balanced and satisfied. Your baby’s greatest need is not just breast milk, but you.
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