Most women produce more than enough milk for their baby (or babies). A small percentage of women have breasts that do not produce enough milk because of insufficient glandular tissue (IGT). Glandular tissue is the milk-making tissue in the breast. The good news is that if you have IGT, it is likely that you can still breastfeed your baby.
The size of a woman’s breasts has no bearing on how much milk she can make. The size of the breast is generally determined by the amount of fatty tissue in the breast (the larger the breast, the more fatty tissue and vice versa). The milk making capability of a breast is determined by the amount of glandular tissue in the breast.
Physical signs that may indicate insufficient glandular tissue
Women who have IGT often struggle with their milk supply, despite good breastfeeding management. Women with IGT may have breasts that are large or small. Often, it is the breast shape and asymmetry that may indicate IGT.
Several of the following physical signs together may suggest a higher risk of milk supply problems due to IGT:1,2
- More than a 4cm flat space between breasts
- Breast asymmetry (one breast is much larger than the other)
- Tubular shaped breasts (the breast has a narrow base and its volume is long rather than round)
- Overly large and bulbous areolae (as if they are a separate structure attached to the breast)
- Absence of breast changes in pregnancy, postnatally, or both
It should be noted that some mothers with one or more of the above physical signs have no problems producing a full milk supply.
Maximising milk supply
However, with any of the above physical signs, a woman may find it helpful to consult an ABA counsellor or a lactation consultant prenatally. They can provide suggestions about how to get breastfeeding off to the best start possible and about options postnatally if there are problems with milk supply.
Some mothers with IGT may find a galactagogue helpful to maximise their supply.
Supplementing and signs of adequate milk intake
If, after taking steps to maximise her own milk supply, a mother with IGT finds that she cannot make a full supply for her baby, she will need to supplement with either donor milk or formula. The amount of supplement required will depend on how much milk she can make on her own. It can help to mix with other breastfeeding mothers (eg by attending local ABA group) as this can help her to become familiar with a breastfed baby’s normal behaviour and gain support. This is important because even mothers who make plenty of milk often worry about their supply being low. Knowing the signs that a baby is getting enough milk is also helpful.
Some mothers with IGT offer all feeds at the breast, even if they are supplementing, by using a breastfeeding supplementer. A breastfeeding supplementer consists of a thin piece of tubing – one end of which goes into the baby’s mouth while he breastfeeds and the other goes into a container that holds the supplement (which may contain the mother’s own expressed breastmilk, donor milk or formula). As the baby feeds at the breast, he consumes both milk from the breast and the supplement, encouraging him to stay sucking at the breast.
For a mother with IGT, it is important that she talks to an ABA counsellor or a lactation consultant about her goals. This way, a plan can be made that suits her own unique needs and circumstances. With support, many mothers can achieve their goals and have successful, fulfilling breastfeeding experiences. Breastfeeding is so much more than the amount of milk a mother is able to make. All breastmilk is precious and valuable to the baby; some is better than none.
Breastfeeding take two
Some mothers with IGT find that for subsequent babies, their supply improves. This is because more glandular tissue is made with each pregnancy and breastfeeding experience.
1. Huggins, K., Petok, E., Mireles, O 2000, Markers of lactation insufficiency: a study of 34 mothers. Current issues in clinical lactation 25-35.
2. West, D., Marasco, L 2008, The Breastfeeding Mother’s Guide to Making More Milk. New York: McGraw-Hill.
The information on this website does not replace the advice of your health care provider.
© Australian Breastfeeding Association August 2017