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Breastfeeding with Insufficient Glandular Tissue
It can be disappointing for some and devastating for others when breastfeeding doesn’t go according to plan. In an effort 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 well-fed. After all, most breastfeeding interferes they are temporary and short. However, for a small minority of women, there are obstacles that no amount of time or effort can overcome.
Insufficient glandular tissue, or IGT, is a rarely discussed condition in which a mother has underdeveloped glands that are less able to produce milk. While many women with this condition also have small breasts, it is important to remember that breast size alone is not a sign of IGT and that most women with small breasts produce enough milk. Rather, IGT is most often manifested by breast hypoplasia (asymmetry or lack of development that can be assessed by a doctor), and many women diagnosed with IGT later report little or no breast change during pregnancy and breastfeeding. A photographic record documenting breast hypoplasia often shows a visually obvious underdevelopment of one or both breasts, but variations in breast shape can vary dramatically among women and the condition is not always visually obvious.
The good news is most women with IGT be able to breastfeed successfully, although in most cases supplementation is necessary. Some women experience only delayed lactation and may later transition to exclusive breastfeeding with sufficient stimulation and temporary supplementation. In a few extremely rare cases, the mother must use formula exclusively.
Here are some tips if you suspect you might have IGT:
O If you are still pregnant, prepare yourself emotionally and tell your doctor about your concerns. One of the biggest difficulties for women with IGT is the disappointment they experience during the postpartum rush of emotions. Many women experience feelings of anger, guilt or inadequacy, especially with a lack of information about IGT. The more you can prepare, the better off you are.
O If your baby has already been born – don’t panic. Remember that most breastfeeding problems, even those related to poor weight gain, can be resolved and are not actually IGT. Contact a lactation consultant to review 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 for you and your child’s caregivers to evaluate when and if supplementation is needed.
O Always stay in touch 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 problem with them prenatally.
O If you recommended supplementing with formula, do so with confidence. Although formula is second only to breast milk, it is a nutritious alternative on which babies not only survive, but thrive.
O Most babies can adapt to both breast and bottle feeding, especially after the first few weeks. If you are concerned about nipple confusion in your newborn, there are many ways to supplement in addition to a bottle, including a dropper or SNS (supplementary nursing system).
O If you wish to continue breastfeeding, remember to always breastfeed First and thoroughly before you give your baby a complementary bottle. Some doctors may also recommend using a hospital electric pump to pump after each feeding to ensure that the breasts have been thoroughly drained. As long as breastfeeding is as frequent and thorough as women without IGT, you will maximize milk production.
Finally, if you have IGT, keep calm and move forward. Whatever you decide, it is important that the mother feels confident and positive about her circumstances and her feeding decisions. Many mothers with IGT go on to have successful and fulfilling breastfeeding relationships. However, breastfeeding with IGT has its own challenges as you cannot fully enjoy the benefits of either or bottle feeding and there can be a number of physical and emotional stresses that only you can judge. If you find that supplementation is too impractical for your condition and decide to bottle feed exclusively, do so without 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 nutrition plan for your child that will not only nourish your child, but create a family situation that will be calm, balanced and satisfied. Your baby’s greatest need is not only breast milk, but also you.
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