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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 an effort to better support and educate new mothers, many breastfeeding advocates are understandably focused on the goal of success, especially with a healthy baby who appears to be feeding well. After all, most barriers to breastfeeding is the fleeting and short. However, a small percentage of women have obstacles that cannot be overcome without time or effort.
Insufficient Glandular Tissue, or IGT, is a rarely discussed condition in which a mother has underdeveloped glands, which make her less able to produce milk. Although many women with this condition also have small breasts, it is important to note that breast size alone does not indicate IGT and that most women with small breasts produce enough milk. Rather, IGT is most marked by breast hypoplasia (asymmetry or underdevelopment that can be assessed by a doctor), and many women diagnosed with IGT later report minor breast changes during pregnancy and breastfeeding. Underdevelopment of one or both breasts is often visually evident in the photographic record documenting breast hypoplasia, but variation in breast shape can vary widely from woman to woman, and the condition is not always visually obvious.
The good news is for most women with IGT can nurse successfully, although in most cases supplementation is required. Some women have only delayed lactation and with sufficient stimulation and short-term supplementation may later resume exclusive breastfeeding. In some extremely rare cases, a mother who has to use only artificial formula.
Here are some tips if you suspect you may have IGT:
o 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 of the postpartum emotional outburst. Many women experience feelings of anger, guilt, or inadequacy, especially when information about IGT is lacking. The more you can prepare, the better off you are.
o If your baby has already been born – do not 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 evaluate your options and get advice on how to maximize your milk production potential.
o Keep a detailed feeding and nappy log. This information will be valuable to you and your child’s caregivers in assessing when and if supplementation is needed.
o Always check with your child’s pediatrician.
o Discuss your concerns about possible IGT with your OB-GYN and/or lactation consultant. Many women diagnosed with IGT report that no one discussed the issue with them prenatally.
o If you recommended supplementing with formula, do so with confidence. Although formula is second best to breast milk, it is a nutritious alternative that babies not only survive on, but thrive on.
o Most babies can adapt to both breast and bottle feeding, especially after the first few weeks. If you are concerned about breast confusion in your newborn, there are many ways to supplement in addition to the bottle, including a dropper or SNS (supplementary feeding system).
o If you want to continue breastfeeding, remember to always breastfeed first of all and thoroughly before you give your baby an extra bottle. Some doctors may also recommend using a hospital-grade electric pump to pump after each feed to ensure the breasts are thoroughly emptied. As long as feeding 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 forward. Whatever you decide, it’s important that the mother feels confident and positive about her circumstances and feeding choices. Many mothers with IGT continue to have successful and fulfilling breastfeeding relationships. However, breastfeeding with IGT has its own challenges, as you cannot fully experience any of the benefits of breastfeeding. or bottle feeding, and there can be a whole host of physical and emotional burdens that only you can appreciate. If you find a supplement too impractical for your circumstances and choose to bottle feed only, do so without any feelings of inadequacy or guilt. As a healthy woman and a whole family with different circumstances and needs, only you can decide on a practical baby feeding plan that not only feeds your baby, but also creates a calm, balanced and satisfied family situation. Your baby’s greatest need is not only breast milk, but you.
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