Hi all,

In 10 years of LC practice, I've only seen one mom that I would truly
describe as having hypoplastic breasts (if that's a good term).  They drooped
a bit, were very white (no pigmented change AT ALL), and were conical shaped
as Becky described.  No milk whatsoever.  I have, however, seen a couple of
other moms with the same sort of shape to the breast but have pigmented
changes.  These moms produce SOME milk, but not enough for their babies, and
need to supplement.

I'm not sure where Miriam got her figures of 1:2000 who physiologically
cannot produce milk, but it may be from the study quoted in Akre's Infant
Feeding:  The physiologic basis on a study in Gambia (?) where out of over
2000 women NONE of them couldn not produce sufficient milk for their babies.
 In the US, of course, we are dealing with other issues, i.e. women with
severe infertility that go to great lengths to have babies that would not be
possible for women in the 3rd world countries.  Some of these women can't
make milk, though not all of them.  (I haven't figured out the common
denominator yet,but I always ask about infertility in my history), Sheehan's
syndrome (those moms would probably have died), breast surgery, etc.  If we
get it down to a common denominator, there are probably only about 1% who
can't produce milk.  The 5% figure came out of Dana Raphael's book who quoted
an article from 1958 who quoted an article from 1935 (can't find that one).
 So, there really haven't been any definitive studies in the US on this
issue.

Jan B.