February 2016
Diana Cessar-Uhl, IBCLC, has written several excellent pieces on hypoplasia or insufficient glandular tissue that would be important for those who work with the mother-baby dyad to read and learn from. What is IGT and why can it be a source of lactation failure?
Cessar-Uhl describes it as "glandular lactation failure...[where] breast shape, placement and symmetry but not size can be indicative of hypoplastic breasts" (2009). A 2000 study found a correlation between these physical characteristics and reduced milk supply:
Plastic surgeons who perform breast augmentation on young women with IGT will frequently refer to hypoplasia as "tuberous breast deformity" or "constricted breast".
There are various articles suggesting evidence as to the cause of IGT: exposure to high levels of certain environmental contaminants (dioxin and other endocrine disruptors) while in utereo (Rudel, Fenton, Ackerman, Euling & Makris, 2011) as well as hormonal and endocrine conditions such as Polysystic Ovarian Syndrome (PCOS), uncontrolled thyroid or insulin-related conditions (Marasco, Marmet & Shell, 2000).
If IGT is noted in pregnancy or immediately postpartum, it should be a yellow flag for you as a health care provider; this dyad needs extra follow-up and assessment for adequate milk production, milk transfer, infant weight gain, and latch difficulties. It should not be a pronouncement made over the woman...as in, "Oh, you'll never make enough milk because you have IGT." One of the best things about the breast tissue is it's ability to grow with the next pregnancy. And some mothers make make sufficient milk with IGT-appearing breasts. We no longer say "never" in lactation, as we continue to learn more and more about the wonders of the female body.
Even with insufficient milk supply, a mother can choose to breastfeed her baby while supplementing with an at-the-breast feeder such as Lact-Aid Supplementer or a Supplemental Nursing System.
Kathy
References:
http://praeclaruspress.com/books/finding-sufficiency/
https://www.motherlove.com/blog/view/milk-supply-mystery-could-it-be-insufficient-glandular-tissue
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