Insufficient glandular tissue (IGT), also known as breast hypoplasia, occurs when the breast does not develop enough milk-producing glandular tissue during puberty or pregnancy. While the exact causes aren’t always clear, several factors are known or suspected to contribute to IGT:
Known or Suspected Causes of IGT:
1. Hormonal and Endocrine Conditions
• Polycystic Ovary Syndrome (PCOS) – May interfere with breast development due to hormonal imbalances.
• Thyroid Disorders – Hypothyroidism or Hashimoto’s can impact lactation by affecting prolactin and milk production.
• Diabetes (Type 1, Type 2, or Gestational) – Insulin resistance may impact glandular tissue development.
• Insufficient Pregnancy Hormone Exposure – Conditions like luteal phase defects or low progesterone can impact breast growth.
2. Genetic Factors
• Some individuals may have inherited a tendency toward underdeveloped glandular tissue.
• Syndromes like Turner Syndrome or Congenital Adrenal Hyperplasia may be associated with atypical breast development.
3. Breast Anatomy and Developmental Factors
• Hypoplastic (Underdeveloped) Breasts – Characterized by widely spaced, tubular, or asymmetrical breasts.
• Absence of Normal Breast Changes in Pregnancy – Lack of growth or tenderness may indicate limited glandular tissue.
4. Exposure to Endocrine Disruptors
• Chemicals such as BPA, phthalates, or pesticides may interfere with normal breast tissue development.
5. Surgical or Physical Trauma
• Breast Reduction or Augmentation Surgery – May remove or damage glandular tissue.
• Chest Trauma or Radiation Therapy – Can affect breast development, especially if occurring before puberty.
6. Unexplained or Multifactorial Causes
• Some cases of IGT have no clear cause, and it may result from a combination of genetic, hormonal, and environmental influences.
Implications for Breastfeeding
• People with IGT may have difficulty producing a full milk supply but can still breastfeed with supplementation if needed.
• Milk supply varies – Some with mild IGT can produce nearly enough milk, while others may struggle to produce any.
• Hormonal support (e.g., domperidone, metformin, or thyroid treatment) may help in some cases.
Managing breastfeeding with insufficient glandular tissue (IGT) can be challenging, but with the right strategies, many parents can still have a meaningful breastfeeding experience. The key is maximizing milk production, supplementing if needed, and protecting the breastfeeding relationship.
Strategies for Managing Breastfeeding with IGT
1. Maximize Milk Production
While IGT means fewer milk-producing glands, some strategies may help optimize output:
• Frequent, Effective Milk Removal – Nursing at least 10–12 times per day in the early weeks can stimulate any available glandular tissue.
• Pumping After Feeds – Using a high-quality double electric pump (or a hospital-grade pump) can help increase stimulation
• Breast Compressions – While nursing or pumping, gentle compression helps drain the breast more effectively.
• Skin-to-Skin Contact – Holding baby skin-to-skin can boost oxytocin and encourage more nursing sessions.
2. Consider Galactagogues (With Caution)
Some people with IGT find that certain medications or supplements help—but results vary:
• Prescription Medications
• Domperidone (where available) may increase prolactin levels and help some people with IGT.
• Metformin (often used for PCOS) may improve insulin sensitivity and support milk production.
• Thyroid medication (if hypothyroidism is present) can improve supply.
• Herbal Supplements (effects vary)
• Goat’s rue may support mammary tissue growth.
• Moringa, shatavari, or fenugreek may help, but response is unpredictable.
• Lecithin or sunflower lecithin can help prevent clogged ducts in those producing small amounts of milk.
⚠️ Note: Galactagogues are most effective when paired with frequent, effective milk removal. They won’t create glandular tissue where none exists.
3. Use an Effective Supplementation Plan
• Supplement as Needed – Many parents with IGT need to supplement to meet their baby’s needs.
• Consider an At-Breast Supplementer (SNS) – A supplemental nursing system (like an SNS or homemade tube system) allows baby to receive extra milk at the breast, maintaining the nursing relationship.
• Paced Bottle Feeding – If bottle-feeding, using paced feeding techniques helps maintain breastfeeding cues and prevents preference for fast milk flow.
4. Set Realistic Expectations and Find Support
• Define Breastfeeding Success for You – Some parents with IGT produce 10–50% of their baby’s needs, while others make little or no milk. Any amount of milk provides benefits!
• Lactation Consultant Support – Working with an IBCLC experienced in IGT can help tailor a feeding plan.
• Mental Health Matters – The emotional side of low milk supply is real. Find support from a lactation consultant, therapist, or peer group (like an IGT-specific support group).
5. Explore Alternative Feeding Options if Needed
• Exclusive Pumping – Some parents find this works better for their situation.
• Donor Milk – If supplementation is needed and human milk is a priority, donor milk (from a milk bank or trusted source) may be an option.
• Formula – If needed, formula is a tool that supports your baby’s nutrition, and using it doesn’t mean failure.
Final Thoughts
• Breastfeeding with IGT is possible but often looks different than the standard experience.
• Success isn’t just about ounces—maintaining the bond, offering comfort nursing, and doing what works for your family is just as important.
• Fed is best, but supported is better! Finding a provider who understands IGT can make all the difference.