To say this was a relief is an understatement. It was equally devastating, since the problem I have is incurable.
It's called mammary hypoplasia, is thought to affect about 1 in 1000 women, and means I have insufficient glandular tissue (IGT). When my breasts were developing back in puberty, I didn't develop enough of the stuff that makes breast milk.
I figured out my diagnosis by reading this article on Reality Sandwich about milk-sharing. When I got to the part where she describes her breasts, I gasped. Other than the size and stretch marks, she could have been describing mine, and she had such a similar breast-feeding experience to me.
I had to know more.
I've now read a bunch of articles about mammary hypoplasia and have learned it doesn't matter what size breasts you have, the common factors you're likely to have are:
- wide space (1+ inches) between breasts (cleavage has never been my strong point)
- asymmetry (two different sized breasts-often pronounced)
- overly large areolae relative to breast size
- tubular shaped appearance of breasts, as they attach to the chest wall in an oval shape between the 3rd and 5th rib, rather than a circle between the 2nd and 6th rib.
- little or no change in breast size during pregnancy
- little or no engorgement or fullness in the typical time period after birth
Mammary hypoplasia has four levels of severity, according to this study. Type 1 is the least severe and type 4 is the most severe. As far as I can judge, I'm a type 2. Which means I have some lactation success, but still can not and will never be able to produce enough breast milk to support my children.
Paul and I were talking last night and both expressed amazement that no one has ever mentioned this condition to me. I had lactation consultants with both L and S and this never came up.
Did they miss it or did they want to spare my feelings? It would have been so much better to have known what's wrong with me four years ago.
I wouldn't have had to smile and nod to the many well-meaning people who have advised me on ways to increase milk supply.
I wouldn't have got my hopes up with each pregnancy, thinking maybe this time my breasts would kick into action and I'd be able to fully breastfeed, only to have that hoped crushed.
I have really mourned my ability to breast feed with J. I have cried so much, feeling like a failure, and wanting better for him than I can give.
In his first few days of life he lost more than 8 percent of his body weight. That's less than the 11 percent L lost, and less than the 10 percent threshold it's usually recommended to introduce formula at, so I almost had hope.
However, he was only having about one wet nappy a day and by day five he still had urates in his nappy - bright orange streaks that show his kidneys are not getting enough fluid to clear them out. This was despite me breastfeeding around the clock, as much as I possibly could.
I made the difficult decision to introduce formula on day five. At first I only gave it by way of the lactaid, but found it so frustrating to use that I switched to bottles after a couple of days.
I tried to introduce formula as slowly as possibly, to see how much I could feed him of my own milk. Unfortunately J didn't gain weight fast enough so I had to keep increasing the formula and now he's drinking the recommended amount of that.
He still feeds off me at every feed, and overnight I try to only offer the breast, but it's mostly for comfort and for whatever antibodies I can provide.
To encourage what milk supply I do have, I'm taking Blessed Thistle capsules and Fenugreek capsules, drinking nursing tea and eating lots of flaxseed and oats.
I've found a lovely breast milk donor through the Facebook group, Human Milk 4 Human Babies, and am going to pick up my first collection of breast milk from her tomorrow. I'm so excited to see how J responds to that, as he often gets a sore tummy on formula. It won't be enough donated milk to do away with the formula completely, but it will at least give J some purely breast milk feeds.
Even though I feel embarassed sharing about my breast problems online, I wanted to do so in case someone else suffers from the same problem I do and doesn't know it.
I also wanted to share it in case any midwives, lactation consultants or other medical professionals are reading. Women can't always make the milk their babies need, and mammary hypoplasia is one of the reasons.
For these women, it can really hurt to be treated like they're doing something wrong, when their bodies are genuinely failing them.
That said, I've felt very supported by all the people I've worked with.