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Breast Hypoplasia is the term used to describe restricted breast development or insufficient glandular tissue (IGT). The majority of women with hypoplasia report no breast growth during pregnancy and experience primary lactation insufficiency. The breasts may appear tubular in shape and have areolar enlargement however the deformity may be asymmetrical. A wide inter-mammary space (3.75cm or greater between the breasts) is indicative of hypoplasia.
Type 1: Round breasts, normal lower medial and lower lateral quadrants
Type 2: Hypoplasia of the lower medial quadrant
Type 3: Hypoplasia of the lower medial and lower lateral quadrants
Type 4: Severe constrictions, minimal breast base
(Categories and Illustration adapted from Heimburg DV, et al, 1996)
Almost all women with hypoplasia will have inadequate milk supply for their infant during the first week postpartum and many are unable to produce sufficient milk to meet their infants' needs by the end of the first month. This is particularly so for those with type 3 and 4 breasts. Antenatal assessment and preparation is recommended in order to optimise breastfeeding success.
The delayed onset of milk production may be stimulated by the use of galactagogues where appropriate and by ensuring complete breast drainage by expressing after each feed. This may be required for an extended period of time i.e. a month or more. Milk supplements may be required and close follow-up after discharge will be essential to ensure baby gains weight and is well hydrated. The signs and symptoms of neonatal dehydration should be clearly understood and assistance sought if baby's output is insufficient (see Intake and Output on this site).
Emotional support will also be beneficial as feelings of inadequacy are common. Comfort nursing may prove rewarding too, as not only can it provide a little milk but it can also be a wonderful bonding time for both mother and baby. Sometimes a supply line may be useful to allow all feeding to occur at the breast. With a good support network a satisfying breastfeeding experience can be achieved - always remembering that some breast milk is better than no breast milk.