IGT - Insufficient Glandular Tissue

IGT is the kind of thing that can sneak up on a woman and steal her dreams away.  It's a sinister condition that many women have, and some don't even know about it.  No one really knows much about it, and it can effect women in different ways.  One primary implication of IGT is a medically valid low breastmilk supply.

While I myself have low supply due to a breast surgery, I have found a safe haven in the IGT community because our problems are so similar.  I am astounded when I find that so many medical professionals, even some lactation specialists, are clueless as to what it is, or how to move forward with a breastfeeding IGT mother.  Especially when you consider that plastic surgeons recognize the physical symptoms of the condition in their patients, and correct them through breast augmentation.  (The augmentation does not increase the chance of breast-feeding success, and may actually diminish your chances.)

If you have IGT here is the breastfeeding story in a nutshell: Your breastfeeding journey may be rocky.  Even if you've had other children in the past each individual pregnancy/infancy will bring with it the question "can I produce enough milk?"  The answer to your question is another question - how much is enough?

Like all nursing mommas, the IGT mom needs to define for herself what a successful nursing relationship is going to be.  For many this means "I will give my baby as much as I can, and I will rejoice in my ability to give it."  Most IGT moms find that for at least some portion of their baby's life they will have to supplement, especially for their first child.

Breastfeeding with IGT can be heartbreaking but it can also leave you feeling accomplished and strong.  If you choose to nurse your baby, and provide whatever you can, it is important to remember that every drop of breastmilk, even half a ml, is better than no breastmilk at all!

So what exactly is IGT?

Breastfeeding relies on the biology of the breast to produce, let down, and eject milk.  A woman with IGT has trouble with the first part, the production of milk.  The breast is contains glandular tissue that is responsible for milk production.  Reaching backward from the nipple are ducts, like tree trunks, that split into ductules, like tree branches, deep inside the breast.  The ductules end in clusters of alveoli, like leaves which produce the milk.  Clusters of alveoli are called lobules, which cluster to form lobes.  A "regular" breast contains up to 20ish lobes.

Insufficient glandular tissue is a condition where there are fewer than average, or less robust, lobes, lobules, alveoli, etc. This can lead to a reduced capacity for milk production and storage.

How does it happen?

Unfortunately  there is no reliable answer to this question.  Some people postulate that IGT is caused by hormonal imbalances, diseases like PCOS.  Other people think it could be related to environmental factors, like toxins and chemicals in our food and water.  Nobody really knows why this happens.

One thing that seems certain is that during puberty when the body begins to develop the dormant tissue of the breast, something did not happen as perfectly as we would wish.  During pregnancy hormones increase glandular tissue production (leading to the common increase in cup size during pregnancy), but this doesn't happen or is not as extreme in women with IGT.

Do I have IGT?

The website noteveryonecanbreastfeed.com has a great self-questionnaire to help you identify risk factors.  If you think you have IGT you can talk to your healthcare professional about getting an actual diagnosis. 

What can I do?

• If you think you have IGT you can talk to your healthcare provider about getting a diagnosis.  This is normally done by an ultrasound of the breast tissue.  Having a diagnosis may give you peace of mind, and also may help you find the resources and tools you need should you decide you want to nurse your babies.
• Get in touch with a CLC or IBCLC who can help you identify weak spots in your plan, develop strategies, optimize latch when the baby is born, etc.  Having a professional support person can make a HUGE difference.
• Keep calm :) stress can level anyone's milk supply, even someone with an abundance of it.  Keeping calm and recognizing the gift you are providing your baby on your own terms will help you and the baby to thrive in your breastfeeding relationship.
• Find some other moms to support you.  Bonus points if they are IGT moms!  You can even find groups online if you don't have luck in your local area.  If you need help finding some buddies, let me know and I can hook you up!
• Many women with IGT find hormone therapies before and during pregnancy (but not while nursing any earlier children) to be beneficial in building up glandular tissue thus improving milk production for subsequent children.
• Educate yourself about the available lactogenic foods, herbs, and other galactagogues that can help you increase your milk supply.  Depending on the severity of your situation and any history with past children you might want to have some on hand.
• Most women with IGT will need to supplement their children's breastmilk intake for at least some portion of the baby's life.  Preparing for this in advance can be really helpful.  There are many ways to supplement a baby (SNS, LactAid, Spoon, Cup, Syringe, Bottle) and many supplement options (various formulas, expressed milk, donated milk, etc.).  Putting some thought into how you will supplement if the need arises can take some of the panic out of your decision to nurse your child.
• Pay attention.  Since we know that IGT moms have low supply it is especially important to watch the little one for hunger cues and signs of good milk transfer (wet diapers, etc.) to insure he or she is getting the nutrition and hydration they need.
• Give yourself a huge hug and a pat on the back!