Tubular hypoplastic breast
There is one exception to the rule about breast size/shape and breastfeeding ability, and that is that some (very few) women have insufficient glandular tissue in their breasts. In other words they simply don't have enough milk producing cells, and these women can then experience milk supply problems. This condition is called breast hypoplasia or hypoplastic breasts.
This kind of breast is underdeveloped (hypoplastic) in terms of the milk glands. They lack normal fullness and may look like 'empty sacks', and may seem bulbous or swollen at the tip. Many times hypoplastic breasts are widely spaced from each other, and narrow at the chest wall. Due to lack of glandular tissue, they have an elongated or tubular form, and often are quite small. The areola can be enlarged. There may be a significant asymmetry. The breasts don't grow during pregnancy and there is no engorgement when the milk is supposed to come in after giving birth.
Scientists don't yet know for sure the reason for this underdevelopment. One theory is that at least in some women it would be linked to too little progesterone, since progesterone mediates the growth of alveoli (milk making glands).
If you happen to have these tubular hypoplastic (under-developed) breasts, talk to a lactation consultant before giving birth. There are measures you can take to try increase your milk supply and your chances of breastfeeding, such as
- have an unmediated birth if possible, and put the baby to the breast right after birth
- nurse often and on cue
- start to pump about three days after birth
- try the herbs fenugreek and blessed thistle or the drug domperidone
- breast compression technique to stimulate more letdowns
Discuss these and other options with the lactation consultant. You may need to supplement with formula, so it is important to observe the baby's output of wet and dirty diapers and weight gain to make sure the baby is getting enough nutrition. Remember also to be happy for whatever breast milk you produce and not blame yourself - even a little is better than none! And if you don't get any milk at all (which does happen), remember it's not your fault. For this kind of situation we can be thankful that the baby formula exists.
Plastic surgeons try to take the most out of women with hypoplastic breasts. Since it is a true medical condition, they try to push these women to get implants to correct the deformity. Having hypoplastic breasts is not any dangerous condition. They look different, and as explained above, women with hypoplastic/tubular
breasts often have difficulties in producing enough milk. It is
understandable to feel bad when you have deformed breasts, and there's nothing
wrong if you wish to have it corrected. Unfortunately the implants will only
lessen the milk supply and the probability of successful breastfeeding, besides
forcing the woman to go through several surgeries throughout her lifetime, and
putting her to a high risk of serious complications and diseases. However, the choice is still yours, of course.
Breastfeeding and underdeveloped (Hypoplastic) breasts
Insufficient glandular tissue at Mothering.com Discussion Forums
Lactation failure due to insufficient glandular development of the breast Pediatrics. 1985 Nov;76(5):823-8.
Patient with insufficient glandular tissue experiences milk supply increase attributed to progesterone treatment for luteal phase defect.
J Hum Lact. 1999 Dec;15(4):339-43.
In this one case, the woman was able to produce enough milk for her second child when she was treated with natural progesterone during that particular pregnancy. Progesterone stimulates the growth of the glandular tissue in breast (alveoli) during pregnancy.
Where’s the milk? Insufficient glandular tissue.
Insufficient glandular tissue (IGT) is a condition first described by Neifert in 1985. The initial series described 17 women who, despite frequent, unlimited feedings with good latch, were unable to establish more than a cursory milk supply. Other cases have been reported since the initial series. These women tended to have little or no breast changes during pregnancy, and more than the usual amount of asymmetry between the breasts. Some women with this problem have been reported as having disproportionately large nipple/areolar areas, “tubular shaped” breasts, and breasts which are widely spaced.
A link between polycystic ovarian syndrome (PCOS) and insufficient milk supply.
PCOS and Breastfeeding - an interview with Lesa Childers, talking about PCOS, low milk supply, and hypoplastic breasts.