Insufficient glandular tissue (breast hypoplasia)

Most mums can produce more than enough milk for their baby (or babies). A small percentage of women have breasts that don’t produce enough milk because of insufficient glandular tissue (IGT).

Glandular tissue is the milk-making tissue in the breast and they don't have enough of it. The good news is that, even if you have IGT, you can probably still breastfeed your baby.   

Generally, the size of your breasts doesn’t affect how much milk you can make. The size of the breast is determined by the amount of fatty tissue in the breast (the larger the breast, the more fatty tissue). How much milk you can make is determined by the amount of glandular tissue in your breast.  

Women who have IGT may have a low milk supply, even though they know how to breastfeed and feed their baby often. 

Breasts may be large or small so it is often the breast shape and asymmetry that suggests IGT.  

If you have several of the following physical signs together, you may have a higher risk of milk supply problems due to IGT: 

• more than a 4cm flat space between breasts 

• one breast naturally much larger than the other 

• Tubular shaped breasts - the breast has a narrow base and a long rather than round shape  

• overly large and bulbous areolae - as if they are a separate structure attached to the breast 

• no breast changes in pregnancy, after birth or both. 

Some mums have one or more of the above physical signs but have no problems making a full milk supply. The opposite is also true. You may have none of the above signs and still have low supply, in which case there may be other reasons.  

• Make a special plan just for you. Talk with an ABA counsellor or a lactation consultant. 
• Think about expressing your colostrum before your baby is born
• Try to get breastfeeding off to the best start possible with lots of skin-to-skin contact with your baby and early, frequent feeds.
• Learn about positioning and attachment.
• Learn about options such as syringe or cup feeding and donor milk.
• Talk to your doctor about whether a galactagogue may help to increase your supply. 

Read about the signs that can help you to know if you are making enough milk. 

If you take steps to make as much milk as you can but find that it still isn’t enough, you will need to supplement with either donor breastmilk or formula. The amount of top-up required will depend on how much milk you can make. 

Depending on the age of your baby and the amount of breastmilk they are taking, you may choose to give the supplements using: 

• A bottle (see information on paced bottle feeding) 

• A syringe or cup 

• A supply line - a device which allows baby to receive a supplement as they suck at the breast.

If you have IGT, it is important to talk to an ABA counsellor or a lactation consultant about your goals. You can make a plan that suits your individual needs and circumstances. With support, many mums can achieve their goals and have successful, fulfilling breastfeeding experiences.  

Breastfeeding is so much more than the amount of milk you are able to make. It’s a relationship with your baby. Any amount of breastmilk is precious and valuable to your baby. 

Some mums with IGT find that for subsequent babies, their supply improves. This is because more glandular tissue is made with each pregnancy and breastfeeding experience. You may have a better experience next time round. 

© Australian Breastfeeding Association May 2022