You did your homework: you took the breastfeeding class, and you read the books. The message seemed simple enough: “Just keep nursing! Of course your body knows how to make milk. After all you, are a mammal.”

After your baby is born you wait for your breasts to get tighter. You wait for the engorgement your friends warned you about.

As the days go on, you notice that your baby is not putting out the recommended wet and dirty diapers. So, you rent a pump to build your milk supply. You pump and pump. You nurse and nurse. Still, your baby is unsatisfied.

It is possible you have hypoplasia of the mammary tissue or Insufficient Glandular Tissue (IGT).

Some of the signs of IGT may include:

  • Widely spaced breasts
  • Stretch marks on your breasts
  • Marked asymmetry between breasts
  • “Door knob” nipples
  • Little or no change in breasts during pregnancy
  • No engorgement or feeling of milk coming in after baby is born

Risk factors for IGT include:

  • Pre-pregnant BMI of greater than 30
  • BMI greater than 26 or 30 during puberty
  • Hormonal disorders
  • Use of hormonal birth control during puberty
  • History of eating disorder or extreme athleticism that delayed or interrupted menstruation

What can you do?

You can try to maximize your milk production by using a hospital-grade pump and hand expressing. You may want to consider galactagogues as well, but you should only start them after you have talked about with your lactation consultant or doctor. Galactagogues are foods, herbs, or medications that aim to increase milk supply, but the data we have on them is conflicting and they can have side effects and interact with some medications.

While you are working to increase your milk supply, you need to make sure your baby is getting enough nourishment. Supplementing with donor milk or formula is vital to make sure your baby is growing appropriately. Many moms may grieve over the breastfeeding experience and therefore use an at-breast supplementer. This is a tube connected to a milk storage container often worn around mom’s neck. The tube is placed at the breast so the baby is taking in the supplement, while simultaneously nursing at the breast.

Remember, breastfeeding is not all or nothing. With help, you can increase the amount of milk you make. Even a small “dose” of your milk is great for your baby.


  • Wide-spaced breasts or stretch marks on breasts are signs of IGT.
  • If you have a history of hormonal disorders or eating disorders, you may be at risk for IGT.
  • You can supplement your milk supply with donor milk or formula to make sure your baby is getting enough nutrition

Last reviewed by Jennifer Lincoln, MD. Review Date: March 2020


  1. Low Milk Supply.
  2. Journal of Human Lactation. A Mother With Glandular Hypoplasia and a Late Preterm Infant.


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