"Success is not final, failure is not fatal: it is the courage to continue that counts." -Winston Churchill

Sunday, December 25, 2011

The Many Faces (well, not faces) of IGT/IR

UPDATE June 14th, 2015:
In the last several years, more research has come out, and I want to edit this post in light of that.
Many of the breasts presented in this post show markers of insulin resistance, which has been linked to insufficient lactation. Diana Cassar-Uhl talks about it  here: http://dianaibclc.com/2014/05/06/insulin-resistance-and-lactation-insufficiency-faq/

We are all unique. No two breasts are exactly alike, and in fact, barring surgical procedures, you'd be hard pressed to find two perfectly symmetrical on the same chest.But just as there are many variations of normal, there are also variations of (and I hate to call it this) abnormal.
Below, I have posted pictures of breasts that have all struggled with milk supply. A huge THANK YOU to all the brave, beautiful women who were willing to share pictures of themselves in the hope that maybe they can help another mother who is struggling with milk supply and looking for answers. IGT has many faces. Just because you don't fit the cookie cutter type 2, 3, or 4, does not mean you don't have IGT.

Typical characteristics of hypoplastic (AKA under-developed AKA tubular or tuberous AKA Insufficient Glandular Tissue) breasts:
  • High mammary fold - the base of the breasts is higher than normal, usually at rib 5.
  • Narrow (flat) breast base - the breast is oval or flattened at the base where it attaches to the rib cage rather than round
  • Breast tissue cascades over mammary fold producing ptosis even in small breasts - breast tissue droops over the high mammary fold
  • Central herniation of breast tissue into the areola resulting in plump nipples
  • Patchy areas of milk producing tissue
  • Little or no prominent veining
  • Large areolas
  • Darkly pigmented areolas
  • Widely spaced breasts > 1.5’
  • Marked asymmetry
  • Stretch marks
  • Little or no growth during pregnancy
  • Little or no engorgement
  • Normal prolactin levels 
 Not every woman with IGT will have ALL of these characteristics, and not every woman with these characteristics will have trouble breastfeeding. The only way to know if you have low milk supply due to IGT is to TRY breastfeeding and keep a close eye on baby's diaper output and weight to determine milk supply.

Onto the boobs!

Pictures of Hypoplastic Breasts (with Type 1 being a normally-developed breast) 
  • Type 2 – Hypoplasia of lower medial quadrant
  • Type 3 - Hypoplasia of the lower medial and lateral quadrants
  • Type 4 - Severe constrictions, minimal breast base

Type 2
Hypoplasia of lower medial quadrant
 Type 3
Hypoplasia of the lower medial and lateral quadrants
Type 4
Severe constrictions, minimal breast base
(Source: http://web.archive.org/web/20060919003432/http://www.leron-line.com/IGT.htm)

Everything in Between

Post  bilateral breast enlargement (under muscle.) 5.5 months postpartum. Child was exclusively breastfed on larger breast.

34, breastfeeding for 6 months (so far).

Age 18, pre-breast augmentation photos.
1 pregnancy, nursing with partial supply 9 mos.

29, 2 pregnancies, nursing this time 8.5 months (+2 months 1st time around)

31, 1 pregnancy, nursed for 5.5 months, pumped to 7 months.

24,  first pregnancy, nursing for almost 3 months.

Age 29, second pregnancy first birth. Been nursing/pumping for 3 1/2 months.

Age 24, has 2 children, nursed/pumped 1st child 2 weeks, nursed 2nd child 6 weeks, pumped until 2nd child was 3 months old. 

"I am now 23 yrs old, pregnant with 2nd baby but 3rd pregnancy and nursed and pumped for 5 months. BUT in the picture i gave you, I was 22 years old, 2nd pregnancy but first baby. This was 30 hours into labor (during pushing stage). i was 41 weeks and 5 days pregnant."

 39.5 yrs old and nursed one child for 6 months (and pumped a TON) Just stopped pumping 2 months ago, at 8 weeks pregnant.  16 weeks pregnant in picture.

 Same mom at 32 weeks pregnant.

34 weeks.

 Mom of three, nursed with supplementation Son #1 for approx 6 weeks, same 
with son #2. Son#3 is approx 30% breastfed. Seems to be some increase in supply this time.

  Nursed for 5 1/2 years (including 8 months tandem) and counting!

26 year old mother of 3. Able to exclusively breastfeed her third child.

 Mom of 4, and one on the way.

 Age 20, first pregnancy, nursing for 2.5 months (at time of picture.)

 Mother of 2, 8 weeks pregnant with third.

Same mom, 6 months postpartum and still nursing. Nursed a total of 17 months (at time of picture.)

Same mom, 10 months postpartum and still nursing.

These pictures were collected by me, and are not to be copied or used for any purpose without explicit, written consent. They are intended only to show other moms possibly dealing with IGT what it can look like, and to show those with IGT that they are not alone. 

Have IGT? Want to share your story? Willing to share a picture of your breasts? E-mail me at nyssaretter@gmail.com RE: IGT


Email Diana Cassar-Uhl, IBCLC and mammary hypoplasia awareness advocate your pictures so that she may use them in her presentations to help doctors and lactation professionals recognize the markers for IGT. Please send them to DianaIBCLC@gmail.com with the subject line "IGT photos." 


  1. Thanks so much to this wonderful mamas for sharing their boobs with us. It was another brave mama whose pic I saw 6 years ago and the light bulb moment happened for me. Suddenly I wasn't the only woman with breasts that looked like that! I wasn't the only one with these breastfeeding problems!! I think these photos and information is so important. So again, thank you.

  2. That's exactly what this is all about. I always thought there was something weird about my breasts, and thought they were unattractive. But I thought it just must be a variation of normal, and had no idea it would impact my milk supply.
    Looking at these pictures, I feel so much less alone, and much less like a freak.
    I'm so thankful that these women were willing to share their photos to help other moms.

  3. This is a bittersweet article. I, too, suffered from Hypoplastic Breasts. I have 2 sons now ages 12 and 7. With my first, I was unable to produce ANY milk at all...and that was trying everything, pumping, manual stimulation, attempting to nurse him every 10 minutes etc. I was so determined to breastfeed that I didn't give up easily and my son started losing a lot of weight in the first week. I had to get formula...there wasn't even any milk to dry up in my breasts. When son #2 was born, I had a tad bit more production than with the first. Still, it wasn't enough to sustain him. I put him to each breast until there was nothing left and gave him a bottle. After about 3 weeks, there was no production at all and I had to give him only formula. I visited my OBGYN and voiced my concerns and he did a breast examination and diagnosed me with Hypoplastic Breasts and told me I would never be able to produce enough milk to sustain an infant exclusively. It's good to know that I'm not the only one out there with a broken heart due to not being able to nourish my babies from my body. Thanks so much for sharing this.

  4. I have not been diagnosed with this condition, but I believe I have it. I have 2 boys, and with my first son I tried to breastfeed him for a week with no success. I had to switch him to formula. I wanted to breastfeed him so badly. I didn't even attempt with my second son. I did however produce a little bit with him a few days after he was born, but it dried up very quick. I also have small breast and am very embarrassed by this. My husband loves me for me, but I am 238lbs and it makes me look flat chested and I am scared that when I lose the weight I will lose what little breast I have. Thank you for sharing this, at least now I know I am not a freak.

    1. I am 30 years old. I have 2 children. I didn't make milk with my first child and I was able to pump and oz each time I pumped but that was all. Growing up and even now I always felt embarrassed by my chest. I have been the same size...half an a cup and very pointed since I was twelve years old. I still hate my breasts. I fluctuateed in weight a lot and can tell you that regardless if I gained or lost weight my breast size never changed. I made it to a full a cup with my second child but the week I quit pumping it disappearred. So for your health's sake and the sake of nd your children's futures lose the weight. Yours boobs won't shrink much.

  5. Thank you so much. The lactation consultants at the hospital I worked with never even mentioned this as a possibility despite pumping/nursing every hour on the hour and only producing 0.5 ounces to 1 ounce after 6 weeks. My supply never increased through pumping/nursing and only marginally increased on fenugreek -- but baby refused fenugreek enhanced milk. I really had no idea this was a possibility and have felt like a failure because of it for so long. I feel relieved now, but still have a lot of sadness over the issue.

  6. I don't want to face this as the truth. I have had 4 children and am about to deliver my 5th child. With each child my breasts topped out at 1 ounce of milk between the 2 breasts. My first born was rushed to the hospital for dehydration because he wasn't getting enough. Each child I have had has had to be bottle fed and I have cried and cried feeling like a failure. My fourth baby even latched like a pro, and I tried medications and pumping and everything. With my 4th child my lactation consultant told me she felt as though it had to do with how my breasts were shaped and how far apart they are. She didn't want to solidly say it was IGT, because there were still studies being done. I think I need to make my peace with breastfeeding, and be grateful that formula exists. Thankyou to everyone who contributed information and photos!!

  7. Wow, I cannot believe that after 4 children I finally have an answer to why I haven't been able to successfully nurse my babies. It is heartbreaking, & relief to have an answer. I was only producing 1 to 1.5 oz from both breast everytime I pumped. I pumped for 3 months along with supplementing with my first baby, I nursed & supplemented for 6 months with my second, with my third I nursed for 4.5 months & supplemented, & my fourth I nursed 5.5 months along with supplementing. It has been frustrating to say the least. I thought I was doing something wrong. I have always hated the way my breasts look. I always knew they looked different than everyone else I knew. I know I am not alone in feeling this way. Thank you all for sharing, & shedding light on the subject.

  8. My whole life I have been embarrassed by my breasts. Always having to wear padded bras and to stuff them. Nothing fits. When i get a bra to fit one breast it just cups over the ither one snd is very uncomfortable. Now to have my first child and not be able to breasts feed has been devistating. I even went to a lactation consultant. This was not mentioned to me. Although after finding this on my own I know she came to this conclusion. I'm just not sure why no one would just explain that I have a medical condition. It's not normal. At least now I can begin to deal with it.

  9. I'm not planning on having kids, but its nice to know I'm not the only one with boobs that are scared of each other <____>

  10. Thank you so much for sharing this information and these pictures. While, I have learned about IGT through studying, it is really helpful to see a wide range of breast shapes and sizes with IGT. The 3 classical shapes they describe really don't cover the real life possibilities.

    Keep up the good work.

  11. After seeing these pictures, and reading various articles, I sincerely believe that I have this too. And it explains SO much. Like why I've never had any growth, unless I gained weight (which means my breasts filled with fat and not glandular tissue!) I've always been small. Never able to get much, if any, milk for my babies after birth. No growth during, or after, pregnancy. Little to none during puberty. And stretch marks all over. I feel so relieved to finally know what it is I have. And to know that there's nothing wrong with me.

  12. This is the first time I have seen photos of breasts that look exactly like mine, and am a nurse and worked 2 years in postpartum! Never heard IGT mentioned back then. My LC mentioned it as a possibility but never confirmed it. My OB-GYN (b4 pregnancy) only asked if my breasts had always been that way. My midwife never mentioned it. A plastic surgeon stated I would need staged reconstruction to fix the asymmetry, tubular shape, large areola etc. I had a lot of sadness over not being able to EBF, especially after taking Bradley classes but getting an epidural in the end (which I was thankful for once she had shoulder dystocia and I got a 3rd deg epis). But I thought at least I could do the BFing right. And it was so difficult to try and nurse every 1.5hours, then syringe supplement, then pump for 15 minutes, all while recovering from a 3rd degree. All the suggestions sounded so good but were so hard to implement when I was exhausted and sore, with a baby who struggled to latch, painful nipples and a screaming baby 90 minutes after nursing for 30 minutes. After 3 weeks I'd reached my limit and felt like a cop out. But I was beginning to wonder if I had PPD and my husband was tired of seeing me and the baby crying. I've certainly made my peace with it now, and look forward to a better experience next time and less devastation if it doesn't turn out. And maybe one day being rich enough to afford breast augmentation! :) THANK YOU so much for sharing.

  13. BTW an SNS worked really well with the LC. In the middle of the night alone, not so much. Lasted about 18 hours and never used again. When you are having to repeat a task every 90 minutes to 3 hours, it needs to be easy. I found SNS, syringe feed, cup feed etc to not be easy.

  14. I am a Lactation Consultant and it is always hard to accept that yes, there are women who really cannot make enough milk. I had adequate milk for my 6 children, so this is painful to even imagine! I am continually pondering on how to help moms in this situation! A couple things I have used and moms appreciated: use your breasts! is still a place of warmth, nurture and bonding for your baby. SNS is complex and laborious, but if used and tweaked correctly, like everything else, it will become easier. It is important that you use quite a small tube size or slightly clamp it, so your baby needs to work on the breast for about 20-30 minutes while getting some BM from you plus the formula/EBM from the SNS.
    For some moms, this is just too much to deal with, but I know there are hell-bent-on-breastfeeding moms that do master SNS and use it longer term. Medela's SNS system and the newer Lact-Aid are both worth looking into. Always challenge the breast and get specialized help. Thanks to all of your sharing on this site, as it also helped me rethink how I help mommies!

  15. This has been a light-bulb moment for me - three children later and I finally understand why I don't make enough milk. No one has ever mentioned this condition before. This explains why I've always hated the look of my breasts - can't wear anything that shows cleavage because it's wonky and too far apart - and now I understand why the way my breasts look has affected milk supply. Does anyone know what causes this problem in the first place?

  16. This has been a light-bulb moment for me - three children later and I finally understand why I don't make enough milk. No one has ever mentioned this condition before. This explains why I've always hated the look of my breasts - can't wear anything that shows cleavage because it's wonky and too far apart - and now I understand why the way my breasts look has affected milk supply. Does anyone know what causes this problem in the first place?

  17. Wow you think my plastic surgeon would have clued me in about my uneven ugly small breast while getting implants. I had CPS called on me for the baby not gaining weight. This happen after I figured out I only made about 1 once of milk and had already been supplementing for 4 weeks. He was in the NICU for first 9 days for apnea and all the medical pros incited that there's enough milk. They were not doing their job. I blamed the implants all this time for lack of milk production and I see pictures and descriptions that fit my breasts. Well I did feed by three children for about 4 months each that single ounce of milk I cried and prayed to produce. I took Reglan, Domperidone, fenugreek and acupuncture. It did help with the second child and I made 3 ounces for a while till the doctor took me off the meds thinking I somehow had established a supply. It dried up after that. I can't believe these doctors and nurses acting like I was crazy and there was no possibility that I might not make enough milk.

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