The Risk of Invalidating Moms Who Say They Can’t Breastfeed

Two months ago I read a poignant account of a pediatrician who wanted desperately to breastfeed and found out after much heartache that she suffered from Insufficient Glandular Tissue.  She tried everything under the sun only to feel judged by breastfeeding advocates:  “Please don’t stare at me as I reach for that bottle and feed my baby and think…I can’t believe she doesn’t breastfeed her baby. Please don’t go all Gisele on me. You don’t know.”  She’s right.

Sometimes when we, as breastfeeding advocates, try to allay the very common fears that moms have that they won’t be able to breastfeed, we can end up invalidating those moms who truly can not breastfeed.  Even if the percentage of mothers who are physically not capable of producing milk is quite small—apparently about 1 in 1000 or much less than one percent—it is important to acknowledge and support women who suffer from insufficient glandular tissue (IGT), the hardware needed to make milk.   And while 1 in 1000 may seem like a small percentage, that translates into 4,000 mothers with IGT giving birth every year, often undiagnosed, and a little more than 4,000 babies, due to multiples.   That’s a lot of suffering and anguish.

Out of curiosity,  I googled around to find other conditions with that risk ratio and found that 4,000 infants are affected with Rh disease every year, 5,000 infants are diagnosed with congenital disorders, and 4,000 live births per year dianosed with Down’s Syndrome.  Those may be lousy comparisons, but I can’t help wonder how many conditions are much better known, diagnosed and treated than IGT with the same risk ratio?  I suspect there are a lot.   How can it be that this particular pediatrician, and all pediatricians and ob/gyns, who are routinely trained to spot conditions far rarer than IGT, are not being educated on the tell-tale warning signs of insufficient glandular tissue?   Why are ob/gyns not taught to examine every pregnant woman’s breasts for signs of IGT, and if there is a likelihood, why are they not coaching women on managing their expectations, letting them know that many women with IGT can go on to breastfeed, or can supplement at the breast, giving the baby and mother the benefits of skin-to-skin, oxytocin (the love hormone) release, bonding, and jaw development that comes with suckling?  Why are hospitals and medical professionals not setting up a routine protocol, like the American Academy of Pediatrics urged for newborn screening, so that those women are monitored in the critical early postpartum phase and are supported to maximize their breastfeeding potential?  Are enough health care providers reading “Making More Milk“? (Our doctor and ob/gyn friends out there, correct me if I’m wrong!)  Some women who have IGT can go on to breastfeed,  and knowing how breastfeeding reduces the risk of so many infections, illnesses and diseases, it would seem that our healthcare system would want to train future physicians to optimize breastfeeding success.   Therefore, one of the most powerful things we can do as breastfeeding advocates is to educate moms, the media, and healthcare professionals about IGT, even if it is relatively rare, and validate and provide resources for those moms who suffer from it. 

And the urgency grows every greater.   There are some who think that environmental toxins and endocrine disruptors such as BPA are playing a role in increased cases of IGT.    Women who need added hormones to sustain a pregnancy are also likelier to have the underlying conditions that result in IGT.  We need the environmental movement and fertility treatment organizations to rally behind this issue, and fight for the rights of moms to get the help they deserve.   We need insurance companies to cover the cost of lactation counseling, breastpumps, supplemental nursing systems and very importantly, donor milk for mothers with IGT.   We need counseling and resources for mothers who grieve the loss of the breastfeeding relationship.

We also need to educate our fellow breastfeeding advocates.  The longer breastfeeding enthusiasts are allowed to judge other mothers, the longer it will take to shift the focus off “the mommy wars” and on to the true barriers to informed infant feeding decisions and the booby traps that keep moms from achieving their breastfeeding goals.  That is one of the many costs of invalidating moms that we can not afford to pay.   If you catch another mom judging someone who bottle-feeds (or actually, judging another mom at all), we hope you will gently but firmly stop her in her tracks (without judging her, LOL)!  

I asked Diana Cassar-Uhl, IBCLC and La Leche League Leader, an expert in this field, to weigh in on this topic and provide a resource list for mothers with IGT or other low milk suply issues.   The resources are below.   Tomorrow I will post a moving and personal story from Diana that makes all of these points hit home.   

Resources for Breastfeeding with Insufficient Glandular Tissue/Mammary Hypoplasia

Making More Milk, by Diana West, IBCLC and Lisa Marasco, IBCLC (can be ordered on

Excellent Overview article, suitable for healthcare providers, about support of breastfeeding with IGT/hypoplasia:

For information about herbal and pharmacological galactagogues:

Do you need to supplement?

 Do you have to supplement with artificial baby milk/formula?

Mothers Overcoming Breastfeeding Issues – outstanding resource for mothers who are grieving breastfeeding experiences that didn’t go as expected or planned

Pictures of hypoplastic breasts:

 Why feed at the breast at all?

46 thoughts on “The Risk of Invalidating Moms Who Say They Can’t Breastfeed

  1. Thank you for posting this! I had unexplained dramatically low supply after my son was born–all the “obvious” things to check for (tongue tie, retained placenta, infrequent feeding, excessive blood loss, hormone imbalances) came up perfectly normal. I felt defective, and my baby was terribly jaundiced by the time we figured it out. I had done everything right: ate well, had an unmedicated full term birth, immediate skin contact, frequent feeding. It seemed completely unfair. And the one of the worst parts was the lactivists who refused to believe I was trying hard enough.

    I was lucky, though. Within 2 weeks of identifying the problem, I was producing enough milk to take my son off formula, thanks to a great LC, a dedicated husband, a baby who loves boobs (even when he could get next to nothing from them!), a good pump, and a nearby compounding pharmacy that provides domperidone. I feel for the moms who aren’t as lucky.


  2. I’m just going to throw it out there that mothers who are unable to breastfeed are unable to breastfeed, period, whether they have a physical, emotional, support, or whatever reason. It’s valid to them, and it should be valid to anyone else as well. As a culture we’ve lost so much knowledge about breastfeeding as well as facing unprecedented synthetic chemical exposure through medications, our food, and almost every consumer product available. There are clearly a myriad of reasons so many women in the United States try but are unable to breastfeed, and every single one of them deserves the same level of support and understanding.


  3. Thank you for writing about this condition. It is quite upsetting to have your concerns dismissed because “only a small percentage of women can’t make enough milk for their babies.” I can tell you that if you’re part of that small percentage, it doesn’t matter how small it is.

    More information and education about IGT is important so we can support all moms who breastfeed, including those who will always need to supplement.


  4. This is a super interesting topic for me. I had low milk supply. Working with an amazing breastfeeding consultant, I was able to maximize my milk supply, but just not ever enough to avoid supplementation.

    A mom like me ends up not really fitting in with the “breast is best” brigade *or* the formula feeders. In the moment, it just adds another layer of shame when a breastfeeding advocate talks about the harm you’re doing to your baby when you don’t breastfeed and instead “choose” formula. Now, nearly two years since my son’s birth, it just makes me mad when I see a comment like that. Mad for all of those mothers that are made to feel even more inadequate than they were already feeling.

    I guess the question is does the end justify the means? Is it ok to invalidate the moms who can’t if you increase the moms who do? I’d like to hope we’re smart enough and compassionate enough to figure out something in between.


    1. Our view is that if we invalidate mothers who truly can not breastfeed, or judge those who decide it is not best for them and their families, then the whole breastfeeding movement will stagnate and fail.


  5. My first son starved for a month and a half due to the well-meaning advice of lactivists. I took every herb in the book, took a “nursing vacation” where I did NOTHING but nurse my son for 2 days straight, pumped and nursed around the clock, and nothing improved my milk. And yet, the first thing that was said to me every time I told someone I didn’t make enough was “Oh, have you tried X?” Yes. And I could write the book on X and every other possible way to improve milk supply. When I finally started supplementing was the first time I was really able to ENJOY my nursing relationship. But even then we never knew what caused it, and I nursed my oldest until he self weaned at 27 months, supplementing until he was eating enough solid foods. When my second came along, and after a week and a half my milk hadn’t come in, I “gave up” easily and had a MUCH more fulfilling nursing relationship with him because of it. He is still nursing at 20 months and I am due next month with my third. I have a deep freezer full of breastmilk thanks to a wonderful mother and this time my baby will get all he needs from the moment he is born. I wish I had the support and knowledge before my first was born so that he didn’t have to suffer as much as he did. 😦


    1. It is such a shame that your situation was not properly diagnosed and addressed from the beginning. Hopefully, someday our first borns won’t have to suffer the consequences of a healthcare system that is not educated in the basics of lactation management. Kudos to you for continuing to nurture and nourish your children at the breast as you were supplementing, you gave them an amazing gift.


  6. Years ago as a LLL Leader I had a friend with her third baby. She had tried nursing her first two and ended up totally on bottles before they were 3 months old due to diagnosed poor supply. With her third baby she was willing to try most anything to make breastfeeding work. Like clockwork she got diagnosed with a baby who wasn’t gaining well. We worked together using more frequent nursing, switch nursing, etc. and finally she tried an SNS. She ended up nursing with the SNS for most of the first year, but once her little girl was well established on solids was able to eliminate the formula supplement. She went on to nurse her daughter for over two years and was thrilled that she finally had the lovely breastfeeding relationship she wanted. While she’s the only mom I ever counseled who seemed to truly not be able to get her supply up to the level needed with normal management, her problem was a real problem, and the solution (at least for her) was a real solution. Not every mom will want to, or even be willing to go to the lengths that she did to nurse a baby.

    IGT is a really good reason to make sure that every mom gets off to the most optimal start possible in the hospital (including eliminating the nonsense of scheduled feeds). Some babies will indeed need supplement very early. In a perfect world this would be human milk, but in reality most of those babies are going to receive some formula. The mechanism by which they receive formula has to ultimately be the mother’s own choice. We can certainly make sure she knows her options. We can definitely encourage her to provide as much milk for her baby as she can. However, in the long run she has to be able to define her own success. That may be, like my friend, nursing for a long time with an SNS, it may be providing colostrum in the hospital and ultimately simply using bottled formula.

    I recommend Making More Milk highly. It’s not judgmental, it’s not overly optimistic or overly pessimistic. It gives all the options. I also think we need to be doing some serious looking at why there’s more women with this problem now than there was a generation or so ago. We found solutions to the RH problem, we found solutions to congenital rubella, we ought to be able to find solutions to this as well.


  7. I totally agree that empathy & education can go a long way in supporting Mothers who have difficulty or cannot breastfeed. I do my best not to judge other Mothers. If I see a baby drinking from a bottle, I have no idea whether it is breastmilk or formula. I think I can help more if the lines of communication are open.


  8. There are too many situations where the physiologic reproductive functions are not possible. Some men have low or zero sperm counts. 10 to 15% of women may need cesarean sections according to the World Health Organization. Some women may lack sufficient glandular tissue to make milk.

    Thank goodness we live in the 21st century, where infertile men can be fabulous fathers, where women can deliver surgically and be wonderful mothers, and where mothers can enjoy the breastfeeding relationship that is far more than the milk.


  9. I had an issue of not producing enough. I breast fed my daughter until 3 months until she was just not getting enough, so I supplemented formula, but then my milk pretty much dried up

    My second pregnancy I had twin boys. I bought a breast pump and talked to a LC. I tried every herb in the book, but it took almost 2 weeks for my milk to come in (they were preemie) and when it did it wasn’t enough for the two boys, so again had to supplement formula. Did that for 2 1/2 months and no matter what I tried I couldn’t increase my milk supply.

    I was so frustrated when I stopped, and It took a whole 24 hours for my milk to dry up the rest of the way (both times)

    I do figure all three of my kids got the good “first milk” and got good skin to skin contact for the first three months. It was all I could do….


      1. Thankyou 🙂 There were times (and still are) that I feel the need to defend myself.

        The fact was when I finally did stop… it was a relief honestly. Breastfeeding was hard and made me feel like a complete failure. It was good knowing that with the formula my kids were getting what they needed to SURVIVE and thrive. I know that breast is best. BUT you aren’t harming you child by feeding formula.


  10. This article and the comments so far make some very important points. It’s great to hear from and about mothers who overcame their disappointment, going on to nurse their children with some supplements, thereby enjoying some of the intangible, joyful aspects of the nursing relationship instead of focusing solely on the properties of the milk being fed. Thanks also for the resources. I will be very interested to read “Making More Milk,” among others.
    I just wanted to suggest that there are two distinct situations which require breastfeeding advocates to emphasize different things:
    1) Educating the public: Reaching out to the general public and/or prospective parents to raise awareness of the importance of breastfeeding and the potential health risks of not breastfeeding. Let’s not fault someone who is providing factual information about these issues as “judging” mothers who cannot or choose not to breastfeed.
    This is different from situation
    2) Working with individual mother/infant dyads. This is the setting in which compassion, active listening, validating and helping the mother to optimize her and her child’s health and emotional well-being may require holding back on some of the more aggressive gung-ho “breastfeeding-by-hook-or-by-crook” approach. I like to remind people that formula supplements which are truly needed tend not to interfere with successful breastfeeding. It’s the unnecessary, ROUTINE supplements that endanger breastfeeding success. (And sometimes we need to redefine success)


  11. I agree so much! I felt I never fit in with either “group” of moms, as I wanted nothing more than to EBF, but became a FF not by choice.

    And Making More Milk was my breastfeeding bible. I finally had a book that related to what I was going through, since most of the other books on my shelf were no help & only made me feel like a failure. I’m nursing my 3rd baby for longest of my children–currently 2.5 months. I am so proud of my accomplishment & know that we’re no where near the end of our relationship yet either! 🙂


  12. I had my first daughter this August and was determined to breast feed as long as possible. At her two week apt. she had lost 9% of her body weight & her pediatrician was concerned. I worked with some amazing lactation consultants over the next few weeks to try and get her back up to birth weight. My daughter was reluctant to latch onto my breast, preferring the use of a nipple shield. She would suck & suck and always seem to be hungry. She was at my breast constantly never seeming satisfied. After numerous consultations with a lactation nurse it was decided that my milk supply just wasn’t sufficient to feed this growing baby. I was heartbroken. I did everything I could, ate healthy, exercised, took the herbal supplement fenugreek, pumped & fed often, yet not enough milk would come in to feed my baby. The nurses were surprised I hadn’t given up. I felt mortified, embarrassed, guilty, a horrible mom. I kept asking ‘why me?’ I wanted nothing more than to provide for my baby. I’m a naturalist, making my own baby food from my garden harvest, etc. so having to supplement with formula has been extremely difficult for me to accept. I was finally prescribed domperidone to help increase my milk supply. I have been on the prescription for a full week as of today and have noticed a slight change in my milk supply. I heard it could take anywhere from 24 hours to 2-3 weeks to fully get into my system & notice if it’s working. I’m wondering if I should expect anything more. Since starting the medication I’ve had to start supplementing with formula in order to fulfill my daughter’s increased appetite (she’s 7 weeks old). I’m still finding it difficult to accept & hope that my milk will magically ‘come in’ so I can go back to only breast milk. Today my daughter magically latched onto my breast without the nipple shield, resulting in some happy tears. I hope things will continue to improve since I have to go back to work on Monday. I plan to pump in order to keep up the milk supply I have. Is there anything else I can do? This is a great website and makes me feel better about my efforts to continue breast feeding. I plan to breast feed all my children, to the best of my ability, no matter what it takes. This forum is very encouraging, knowing I’m not alone.


    1. Your post brought tears to my eyes. I can relate to your resolve. Although I have been lucky enough to not have had any significant issues with breastfeeding my child I was froced to give up my completely natural birth plan in favour of a surgical birth when my already 2 weeks overdue son’s heart rate dropped frighteningly low on every contraction when I was still only 2cm dialated. I still cry sometimes when I tink about it. I wanted so badly to bring him into the world “untainted” by anything artificial and there I was having a spinal with a variety of drugs pumped through it before he was delivered. It was heartbreaking, but on the other hand he is now an alive, active and healthy 16 month old who brings indescribable joy to my life every day. That might not be the case if I had not allowed for his birth to be “unnatural”.

      I’m impressed with your dedication – I know myself and I would be the same way – but just remember that you can’t control everything, and that sometimes we have to let go of what we think is best in order to provide the best. I’m NOT saying give up, I’m saying don’t be too hard on yourself for doing what you have to do to provide the best for your child, and YES sometimes formula is the best if it means your child is not starving!

      Keep up the awesome work!


  13. Im 21 with my second child. my frist was exactly the same as my first but i was a bit unsure of myself back then because i had zero support (living 4,000 miles from a mom who doesnt want to “influence” my choices) my first was FF from 5 months on. My second is now 6 months old and im not giving up. I dont want to give him solids for fear i dont have enough milk as it is and i might be even worse off. so far i think its going good though and he has gone from 490g to 520g or in other words 11 lbs to 11.5 lbs just in 3 weeks or so. He was born at 8.12 lbs dropped down to 7.0 (my first son was 7.1 when he was born) my second took a month just to get back to his birth weight. I have got my hands on a brest pump for the time being as it gives me a load of confidence but i never get more than 1 oz out of it. i did give my son a bottle of formula and he only had 2 ounces. i just need him to eat longer instead of snacking at the breast all day and some solids but it still seems like my breast milk is going down. he isnt breastfeeding anymore than he was before in fact its a whole lot less and the solids seem to keep him satisfied for hours, even when i put him to my breast he turns away. I have held him every moment since he was born and constantly nursed him for the last 6 months, I am not giving up because i know i can get through this with him. I just need a hat to cover the bald spots from ripping my hair out 😉


  14. It is my (unofficial) observation that not being able to breastfeed is MUCH more of an epidemic than most people are aware of.

    I have had two boys who I was passionate about breastfeeding, got THE best help in the area from lactation consultants, midwives, and doctors. Fed and pumped night and day, took every herb in the book, ate every food (and drink) I could find as a galactogogue and still had to supplement at weeks old.

    I wrote about my experience on my blog I have since heard from at least 100+ women who have had my exact same experience. They also heard from doctors and lactation consultants that “it is too rare” and so they were looked at as liars or failures. I don’t get a ton of traffic, so I am guessing that at least 10% of the women who have come to my site have had my exact same experience.

    After a lot of research I now believe there to be dietary, hormonal, and environmental triggers. A lack of good fats in the diet; out of whack thyroid/adrenals/progesterone/estrogen; and things like fluoride, birth control pills, and too many soy products in the diet have all been shown to have adverse effects on milk supply.

    For every woman above who has told their story I have heard from a dozen more. We feel alone. We feel insufficient. We feel judged. And rather than debate whether or not it is “true” that a woman can’t breastfeed, I’d like to see some action as far as more scientific research into why, because it is an epidemic.


    1. Shannon, thank you so much for writing and we agree. My sense too is that the numbers of women with low milk supply issues is increasing and that it is a silent epidemic. I hope with strength in numbers that women will fight for funding for research for this, and will raise awareness, and find solutions for moms!


  15. I’m going to have to agree and disagree.

    I agree that we should be supporting moms with low supply. I agree that we should be exploring maternal causes of low supply. Further, I agree that we should be the roots of those maternal issues. And I absolutely agree with the suggestion for Making More Milk. Those ladies are amazing and know their stuff!!

    My problem with this article is that when you scold the “breastfeeding advocates” (lactavists, from here) for being “judgemental,” you’re judging lactavists, as a whole, which is entirely inappropriate. In general, I’m finding more and more that you cannot talk breastfeeding in our society without be accused of being judgemental, and I think that your article here doesn’t make it any easier because right there in bold, you say that lactavists are judgemental.

    How do we overcome this when a site dedicated to breastfeeding is furthering the divide: lactavists vs. everyone else? Am I really the only one who has read this article and has a problem with what appears to be a huge part of the message?

    Here’s what I know about lactavists, from my personal experience, and I know quite a few: Many of us, for whatever reason from little to no support to medical problems, have been forced into the situation of feeding our babies formula at some point. The vast majority of us would NEVER be so rude as to stop someone at any point and belittle them for feeding their baby formula. Even more of us have been made to feel like crap for doing what is normal and standard for our babies and thinking that it’s important. Even more of us have been told that we’re disgusting, looking for attention, only breastfeeding for ourselves, sexualing abusing our nursing toddlers, indecent, exposing ourselves, etc. etc. Yet, lactavists are always the bad guys when the subject of infant nutrition comes up. With that same token, lactavists are the ones that are working their butts off to become IBCLCs. They are our LLL leaders. They are the ones helping to make breastfeeding normal in our society.

    In my opinion, you missed the mark here. Can we not write an article about breastfeeding issues without calling anyone names? I’ve been a fan of your site, enjoyed a lot of your articles, but I think this cross the line. I think that it really detracts from your message, which is moms with IGT need more support. I guess that’s how you get more mainstream readers though. Blame the lactavists.


    1. Thank you so much for writing and I am so glad you spoke up. I am not scolding either breastfeeding advocates or lactivists. I was very careful to use the term “breastfeeding enthusiast” and maybe that is not even the right term . . . what I mean to pinpoint here as unacceptable are the comments I’ve seen across popular parenting and social media websites where a commenter calls women who “don’t” breastfeed “lazy, selfish, not committed enough” etc. etc. — I have heard those kind of comments from friends of friends or moms I’ve spoken to generally who breastfed themselves but are not true lactivists or advocates in my book because they are not at all educated about the issue. They just think that if they could do it everyone can. Allowing comments like that to go unchallenged is making it hard for the rest of us. This post explained it beautifully: As true advocates and lactivists, we need to distinguish ourselves and the loving, compassionate way we work with moms from those who are not educated and are causing a negative public perception of advocates. In fact, just as we need to bring about a culture that embraces breastfeeding, we need to bring about a culture that embraces breastfeeding advocates, and doesn’t continue to dismiss them or marginalize them all because a few vocal judgmental types are calling women names and hijacking the public perception of all advocates.


    2. I agree.

      There are a lot of people chiming in with “I’m tired of hearing ‘have you tried..?'”, so I feel that it’s necessary to add that I am NOT tired of it, and that I am very thankful for it, and I don’t understand the sentiment because quite a few of the comments relate situations where had they NOT kept trying with the help of encouraging people in their life, they would not have successfully breastfed.

      In our situation, we were dealing with an area where the medical staff at both local hospitals, and the first three paediatricians we went to, all of whom had lactician consultants, all ranged from openly hostile to breastfeeding to woefully ignorant. The nurse assigned to care for me immediately after birth actually said “your breasts are far too huge to nurse a baby, you’ll smother her!” Our our paediatrician threatened us if we continued to nurse after the three month mark. In public, we were spat at, even though we nursed using discreet tops and blankets, and had to endure random strangers asking if she wasn’t old enough to “stop doing that yet”.

      Enduring all of that, mostly on our own, was hard. And I believe that if it were not a few weeks of very supportive in laws, I would have given up, sad and defeated that I couldn’t do it. The truth was that I could, and I just needed more help, more support, and more suggestions.


  16. As with many other Moms here, I find myself in the breast/formula twilight with little support. I am tired of hearing “Well, have you tried blah…” when talking about low milk supply. I have tried everything except prescription drugs to increase my supply. I now nurse my 10 week old daughter when ever it is leisurely for us and then follow that nurse with a bottle of formula. Each feeding takes us an hour if we nurse together. I am blessed with this time, however I do just bottle feed her with formula too. She is getting sustenance from the bottle and nurture from the breast. This is how I define my success.


  17. Please remember too there are other issues–my best friend had breast cancer diagnosed while pregnant. She went on chemo while pregnant, and had to deliver her baby early so she could have a mastectomy on what should have been her due date. The “helpful advice” was so painful for her that one day she snapped at someone who was gently chiding her that “breast is best” and explained that hers were removed. (The advice giver, btw, was undaunted, wandering off with a “but still…”) I was embarrassed to be a breastfeeding counselor that day. Thank you for this. I think the message is out there that breast is best, but we are all so lucky to live in a time when babies can still thrive without breastmilk.


    1. I too am a THRIVER — lost BOTH my breasts to breast cancer at age 37 — read my post for more My Breast Cancer: Why I Won’t Race for the Cure. And so I absolutely stand with you and your friend! I have been in those shoes before and replied in the same manner. It is exactly for this reason that we need to keep putting the focus on the Booby Traps that keep moms — especially “breast-less” moms like myself and your friend – from making informed decisions about how they will feed their baby, and that includes counseling them about OPTIONS. The preferred “next best” supplement to formula is screened, pasteurized donor milk from an HMBNA milk bank. And the “next best” thing to breastfeeding is not bottle feeding, but can be a substitute experience that still confers many benefits for both your health and your baby’s. If I had gone on to have a third baby, I would have used donor milk, and I might have even used a “supplementer” near my implants so I could still give and receive some of the pleasures and benefits of “nursing.” It’s a tragedy that doctors, nurses and hospitals are not educated about the value of not only donor milk, but of the tremendous benefits that still come with the the behavior and process of breastfeeding – i.e., skin-to-skin, providing warmth, security, familiar bodily sounds and a visual field (10 inches is all newborns can see) to soothe, and if you are capable of using one breast — the euphoric feeling that accompanies the release of the love hormone (oxytocin) when the baby suckles and stimulates a “let-down.” And those babies who eat at the breast still may receive many of the benefits of breastfeeding – reduced risk of SIDS, obesity from overfeeding. Many moms who have undergone single or double mastectomies, or who have one of the other low milk supply issues, have had very rewarding experiences (read many examples in these comments) using their bodies as nourishment even without a full milk supply — or even a breast.


      1. A wet nurse, donated unpasturized milk, homemade natural formula are all options I would use before a manufactured formula.


  18. As a lactation consultant for over 25 years, former breastfeeding mother, labor and delivery nurse who is currently counseling women who are trauma survivors, I see a combination of everything that has been experienced here as a huge contributing factor to insufficient milk supply. For those women with insufficent glandular tissue, the truth is, it’s a Forrest Gump situation. . it’s like a box of chocolates. . .until you lactate, you don’t know (short of medical imaging to visualize, which of course, would have a prohibitive cost!). I have seen moms with teeny breasts produce huge amounts of milk (myself included!)and large breasted women struggle to produce milk. I believe that the hormones added to foods, early use of birth control methods, chronic low/non-fat diets, and chronic poor nutrition as well as chronic stress and poor self-image are all contributors to the “epidemic” of poor milk supply.
    I believe many well-intended lactation consultants push the envelope with a mother’s desire to breastfeed and take on a purist approach which is rarely warranted. Each mother should be thoroughly assessed, listened to, and determine her own way with gentle guidance from lactation professionals or lay leaders. Supplementation post the first week should not be vilified once insufficiency has been determined. There is a delicate balance between advocacy and activism.


  19. I am so excited to see that someone is finally talking about IGT!!! I have struggled through that with my first and am 6 months into it with my second. It was truly a traumatic experience the first time around and I wish soooo much there would have been more information out there to help me understand what was going on! My lactation consultant and LLL both didn’t know about IGT and were no help. I had to figure things out mostly on my own…and since I was very determined I was able to nurse my first until just after she turned a year and supplemented with donated breastmilk. With my second I have slightly more milk and hope to nurse well past a year! I love breastfeeding and would love to see a lot more info and research about IGT.


  20. Thank you for this excellent article. I was one of those smug first time moms with an over supply who judged those who formula fed. 2.5 years after my som was born I was dx with breast cancer. I have been fortunate enough to be blessed with a daughter who is now 6 wks old. My right breast does not produce any milk due to treatment. So far my left breast has been making enough but we do supplement with one bottle of donor milk a day. This experience has been very humbling and I will never judge again.


    1. Thank you for sharing your story. Being that honest and humble is very brave and very rare. You have inspired and touched me! Your honesty sets a wonderful example for other moms and a society which judges too much. Enjoy your daughter!


  21. I know this is an old article, but I just ran across it. I want to say thank you for your non-judgmental attitude. While I didn’t have IGT, and in fact was able to produce enough for my daughter, I did end up exclusively pumping. I got several dirty looks from people who didn’t understand, who saw me pull out a bottle and assumed it was formula. No, it was breastmilk that I worked really hard to get! I never judge anyone with a bottle, because you just never know what brought that mama to the point of using it.

    I think I “gave up” and switched to pumping mostly out of fear of IGT. I have Poly-Cystic Ovary Syndrome, which made IGT a real possibility for me. I’m not sure if you are aware or not, but about 1/3 of moms with PCOS will have some level of IGT as well, due to the hormonal imbalance during puberty causing the glandular tissue not to grow. This site has a nice overview of PCOS and breastfeeding:

    I do know that now that I know I can make enough milk for a baby, I am even more committed to exclusively breastfeeding my next child.


  22. What is your source for stating incidence of IGT is only 0.1%? Do you have a reference for rate of low supply moms (IGT, hormonal, other reasons)?


  23. I know this is an old post, but there are not a lot of articles about IGT or Hypoplasia. The focus and importance of this article is the lack of awareness and education in the breast feeding related field, which I am grateful. When I was 13 a fellow girlfriend at a pool party said to me while in our swimsuits, “Gee Julie, you have a cute figure but your boobs sure look funny”.

    I always thought they looked different, but no one else ever said anything…until I was 8 mo pg with #1. A co-worker said, “Gee Julie, you are all belly…seriosly, your boobs haven’t even gotten bigger”. Hmmm. My #1 is born, she latches we have skin to skin, but she is never satisfied. By day 4 my Ped tells me #1 has lost 1lb and to give her 1 oz of pedialyte if no wet diaper after 12 hours, as well as let my breasts rest for 3 hours then pump for the 1st time. We give the 1 oz and her eyes nearly rolled back into her head with obvious relief. I waited 3 hrs, pumped and produced 1 ounce of breat milk. It dawned on me that our infant was starving and in tears told my husband we needed to give her another 1 oz of formula while I continued to breast feed to get through the weekend until we saw the ped again. I spoke to her Ped the next day and she said we did the right thing.

    That Sunday we poured over breastfeeding books to figure out what was going and I stumbled upon a sketch of breasts. They looked just like mine. And this one paragraph in the whole book mentioned for the 1st tiime, IGT. I knew this was me.

    When we went to see the Ped Monday she asked me if I would be okay if she examined my breasts, which was fine. I told her that I think I have IGT and she agreed. She said I was the 1st case she has encountered.

    I used Domerperidone, rented a hospital grade pump, took the herbals…but the hassle after 30 days made it more about me and the machine and the process and not about me and my child. We switched 100% to bottles and practiced attachment parenting with the bottle feeding.

    Now, 24 weeks pregnant with #2. I plan to use a SNS w/formula, some new herbal supplements, no more Domperidone (I didn’t like how it made me feel), and focus on bonding. I accept that I have this rare condition and will see where my strategy takes us!


  24. I know this article is a few years old but I’m glad I found it. I’m writing from England and it seems that little is known about this problem here. I too struggled with breastfeeding. My daughter was hospitalised twice for weight loss and with urates in her nappy. I was put on a feeding plan of breastfeeding, supplementing formula and pumping. I did not sleep until the 6th day. Everyone kept asking me if my breasts were tingling or feeling full but I felt nothing. I couldn’t pump more than 1/2 an oz and that was from both breasts. I spent days. In the house with he curtains drawn doing skin to skin and breastfeeding. My baby cried endlessly as did I. If tears were breastmilk I would have been fine. ‘Breastfeeding support workers’ came to my house daily with knitted boobs in hand to correct my latch. The truth was my baby latched brilliantly. It was me that had the problem but these support workers are not medically trained; they are women in the community who happen to have breastfed successfully and think anyone can do it.
    I tried everything to boost supply -pumping, herbs, diet and in the end managed to convince my gp to give me domperidone ( which gave me horrendous diarrhoea ). I saw a marginal increase but only from 1/2 an oz to just under an oz. I prayed my baby was better at getting milk than my pump. I came to my own conclusion that breastmilk could only ever be medicinal for my daughter. I was never going to be able to ebf.
    At 12 weeks old she started refusing to breastfeed. She would scream and turn away. Who could blame her? I cried bitter tears and continued to pump. Then I got an unrelated infection and struggled to pump for the hours it would take me to get an oz. I decided it was the end of the road.
    Nobody has ever examined my breasts but I’m fairly sure they are hypoplastic. The markers are there. Thank you for your article. I wish there was more understanding of this problem


    1. This is such a frightening story, Liana. And thank goodness you were producing enough milk that your baby didn’t become dehydrated. Did the pediatrician say anything at the weigh-ins?! You know, I think the well-being of the baby can get lost in this discussion. On one hand are skeptics who deny that IGT exists at all. On the other are we mothers whose hearts are broken with disappointment and shame. And in the middle is a starving baby that no one seems to be paying much attention to. E.g. “It’s only been a week, your milk will come in.” As someone who was able to produce max 2 oz per day let me tell you, a baby who is getting little or no milk is not thinking “it’s only been a week.” She is starting to *stop* crying because she’s too weak to ask for help. The sooner the medical community recognizes – really recognizes, not gives it a “but it’s so rare” hand wave – the sooner they can look for trouble during pregnancy and subsequently protect newborns after birth. Breastfeeding should be done to support the newborn, not at the expense of the newborn!!


  25. I too, had a low milk supply with my first. After reading various resources, I suspect I have IGT. My breast is small and asymmetric.
    With my second baby, I tried hard to exclusively breastfeed her. I managed to do it, but with very frequent nursing and pumping.
    I think I am one of the lucky mom who was able to breastfeed despite of facing this problem. I don’t know whether I’ll get the same opportunity to breastfeed my subsequent babies, but I really hope so.
    I’d love to know more information regarding IGT, and whether we can do more things to maximize our breastfeeding chance.


  26. WOW! YEP!! I am almost a hard-core breastmilk activist and I will suggest breastmilk as much as possible. However yes this exact condition is rarely discussed! Even by lactation consults, not many seem to even consider it or maybe they don’t know?

    It was not until my second baby that someone suggested something kind of similar. They said maybe you don’t have the right hormones or something?

    It was actually when I was trying to breastfeed my 3rd child that it was brought up, suggested and everything finally clicked and was connected! The total span of years was 8 years and 3 kids just to finally learn and figure out what on earth was even going on!

    Here I am, 5 kids in, now I know what to do and all that. Yet I still do not see much info about it among message boards and even within Facebook groups that are for breastfeeding.


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