Some women’s breasts can’t make enough milk, and the effects can be devastating

Sometimes not enough glandular tissue, shown here as lobules, develop. Tsuyna/Shutterstock^[8]

We don’t know how common^[9] this is. But it has been linked^[10] with lower rates of exclusive breastfeeding.

We also don’t know what causes it, with much of the research conducted in animals^[11] and not humans.

However, certain health conditions have been associated with it, including polycystic ovary syndrome^[12] and other endocrine (hormonal) conditions. A high body-mass index around the time of puberty may be another indicator^[13].

Read more: Why do men have nipples?^[14]

Could I have breast hypoplasia?

Our survey^[15] and other research give clues about who may have breast hypoplasia.

But it’s important to note these characteristics are indicators and do not mean women exhibiting them will definitely be unable to exclusively breastfeed.

Indicators include:

• a wider than usual gap^[16] between the breasts

• tubular-shaped^[17] (rather than round) breasts

• asymmetric^[18] breasts (where the breasts are different sizes or shapes)

• lack of breast growth in pregnancy

• a delay^[19] in or absence of breast fullness in the days after giving birth

In our survey, 72% of women with low milk supply had breasts that did not change appearance during pregnancy, and about 70% reported at least one irregular-shaped^[20] breast.

Read more: 5 expert tips on how to look after your baby in a heatwave^[21]

The effects

Mothers with low milk supply – whether or not they have breast hyoplasia or some other condition that limits their ability to produce enough milk – report a range of emotions.

Research, including our own^[22], shows this ranges from frustration, confusion and surprise to intense or profound feelings of failure, guilt, grief and despair.

Some mothers describe “breastfeeding grief^[23]” – a prolonged sense of loss or failure, due to being unable to connect with and nourish their baby through breastfeeding in the way they had hoped.

These feelings of failure, guilt, grief and despair can trigger symptoms of anxiety and depression^[24] for some women.

Feelings of failure, guilt, grief and despair were common. Bricolage/Shutterstock^[25]

One woman told us:

[I became] so angry and upset with my body for not being able to produce enough milk.

Many women’s emotions intensified when they discovered that despite all their hard work, they were still unable to breastfeed their babies as planned. A few women described reaching their “breaking point”, and their experience felt “like death”, “the worst day of [my] life” or “hell”.

One participant told us:

I finally learned that ‘all women make enough milk’ was a lie. No amount of education or determination would make my breasts work. I felt deceived and let down by all my medical providers. How dare they have no answers for me when I desperately just wanted to feed my child naturally.

Others told us how they learned to accept their situation. Some women said they were relieved their infant was “finally satisfied” when they began supplementing with formula. One resolved to:

prioritise time with [my] baby over pumping for such little amounts.

Read more: If you're feeding with formula, here's what you can do to promote your baby's healthy growth^[26]

Where to go for help

If you are struggling with low milk supply, it can help to see a lactation consultant^[27] for support and to determine the possible cause.

This will involve helping you try different strategies, such as optimising positioning and attachment^[28] during breastfeeding, or breastfeeding/expressing more frequently^[29]. You may need to consider taking a medication, such as domperidone^[30], to see if your supply increases.

Read more: Domperidone can boost breast milk supply – here's what you need know^[31]

If these strategies do not help, there may be an underlying reason why you can’t make enough milk, such as insufficient glandular tissue (a confirmed inability to make a full supply due to breast hypoplasia).

Even if you have breast hypoplasia, you can still breastfeed by giving your baby extra milk (donor milk or formula) via a bottle or using a supplementer^[32] (which involves delivering milk at the breast via a tube linked to a bottle).

More resources

The following websites offer further information and support:

Shannon Bennetts, a research fellow at La Trobe University, contributed to this article.

Read more https://theconversation.com/some-womens-breasts-cant-make-enough-milk-and-the-effects-can-be-devastating-224858