Breast Hypoplasia

Breast hypoplasia means that the breast tissue did not mature fully and therefore, the breast(s) may not be able to produce enough milk to fully feed a baby.

Breast Maturation begins at puberty. Alveolar cells (milk producers) are made with each menstrual cycle, and more so with every pregnancy. Breast tissue is made of alveolar cells, ductal structures and fatty tissue.

**The size of a breast does not determine how much milk it will produce. However, certain breast shapes may not be able to produce an over-abundance of milk and occasionally, may not make enough milk to feed the infant.

Remember that with every pregnancy, you will make more alveolar tissue and more milk than the previous pregnancy.

Breasts at risk for low production include (see photos):

• Cone shaped breasts with nipples that point to the outside, rather than pointing forward
• Large breasts that "hang" from a small area connecting them to the chest wall
• Wide space between the breasts
• Breasts whose areolae form a mound, distinctly separate from the contour line of the rest of the breast tissue.
• Asymetric (very different size) breasts where one of the breast shows lack of development

Possible causes for breast hypoplasia include:

• Polycystic Ovarian Syndrome
• Insulin Resistance
• Thyroid Dysfunction during puberty
• Increased Testosterone Levels
• Pituitary tumors
• Pituitary Insufficiency
• Growth Hormone Deficiency
• Late Onset Congenital Adrenal Hyperplasia

What you can do to improve milk production outcomes

If you are pregnant and concerned about whether or not you will produce enough milk, speak with your healthcare provider/lactation consultant and follow these guidelines to get the best possible start:

If you are in your first trimester and you are not feeling breast tenderness or increase in size, ask you doctor to evaluate your progesterone levels.

If you think you may have insulin resistance or polycystic ovarian syndrome, speak with your doctor about taking metformin during and after the pregnancy. See Insulin Resistance article.

After delivery, Try to get the baby to nurse within the first half hour to hour after birth. Continue to nurse on que (at least every 2-3 hours), including the middle of the night.

Starting in the hospital or (home if homebirth), pump after feeds, every 2 to 3 hours. Ask the nurses and lactation consultants in the hospital to help you learn to use the hospital grade pump. Massage the breasts gently while pumping.

Pump for 5-15 minutes. Stop sooner than 15 minutes if no milk is coming out.

Get baby weighed daily, if he/she has lost more than 10% of birthweight, you should offer expressed breastmilk or formula to the baby after each nursing. See methods of supplementation. If he/she has not lost more than 10% of birthweight, continue to nurse on que, pump as directed below and make sure to get the baby evaluated by the pediatrician on the day after hospital discharge and then every 2-3 days until you and the pediatrician are sure that he is getting enough milk. If baby is not gaining weight, see low production pages.