Insufficient Glandular Tissue (IGT)

Breastfeeding doesn’t always work out the way we expect. For some mums, despite all the time, effort, support and heart they pour in, their milk supply can still feel like an uphill battle. It can be really disheartening when you’re doing everything 'right' and still feel like it’s not quite working the way you hoped. If you’re in that space, please know you’re not alone.

One possible reason for ongoing low milk supply is a condition called Insufficient Glandular Tissue (IGT), sometimes also referred to as breast hypoplasia. This is a physical condition that can influence how much breastmilk your body is able to produce. For women with IGT, during puberty the breast doesn’t develop enough glandular tissue (the tissue which makes milk) as would generally occur during this time. This can mean that when they then go on to become pregnant and start breastfeeding, there just isn’t enough of the milk-making tissue there to produce a full milk supply.

There are some physical signs that may point toward IGT, such as breasts that are widely spaced, appear tubular in shape, or a lack of noticeable breast changes during pregnancy or after birth. But it’s important to know that these signs are not always obvious or definitive, and having them doesn’t automatically mean you’ll have low supply. Likewise, some women with IGT may not display any visible signs at all. IGT is really a diagnosis of exclusion, where we have accounted for all other potential causes of low milk supply.

If you do have IGT, it doesn’t necessarily mean you need to stop breastfeeding.

Many women with IGT continue to breastfeed. This may include mixed feeding with donor milk or formula supplementation, or using tools like a supplemental nursing system (SNS). An SNS allows your baby to receive extra milk (whether that’s expressed breastmilk, donor milk or formula) through a thin tube at the breast, so they can continue to breastfeed while getting the extra calories and volume of the supplemental feed. For many families, this can be a lovely way to support their breastfeeding journey and continue offering the comfort and closeness that feeding at the breast provides.

The photos above are of beautiful mama Shannon, breastfeeding her little boy while also using a SNS with donor breastmilk. Photos gratefully shared with permission.

Even small amounts of breastmilk provide significant benefits for your baby. One of the reasons for this is the high concentration of antibodies in breastmilk, especially secretory Immunoglobulin A (sIgA). sIgA helps protect your baby from infections and inflammation by neutralising pathogens before they can cause harm. Colostrum, the first milk produced in the early days after birth is particularly rich in sIgA. As milk volume increases, the concentration of sIgA decreases. This means that even small volumes of breastmilk can be incredibly protective because of the high concentration of antibodies. Human Milk Oligosaccharides (HMOs) are unique and complex carbohydrates found abundantly in human breastmilk. HMOs help shape your baby’s gut microbiome by feeding beneficial gut bacteria, especially Bifidobacteria. Because HMOs are unique to human milk, they’re one of the ways that breastfeeding continues to protect and support a baby's health.

Every drop of breastmilk, regardless of total volume, contributes to your baby's immune defence, microbiome and overall health.

But what I think is most important, far beyond how much milk you make, is that you feel seen and supported. That your feeding plan feels sustainable, emotionally safe, and aligned with your goals. At Held Midwifery, we believe in care that takes into account the whole picture, not just how much milk you are making. Because feeding is about so much more than just supply. It’s about connection, closeness, and being supported in whatever path feels right for you and your baby.

If you’re experiencing low supply, wondering about IGT, or just feeling unsure of what’s going on we would love to help. Book a lactation consultation Hannah or Nerissa here.

Photo credit: Justine Edwards Photography @justineedwardsphotography_