Regarding hypoplasia:
I once posted a full report about a mom I saw between pregnancies to prevent a completely different problem, and remarked that in investigating (between pregnancies) a complaint about painful nipples with her previous child, I had failed to have her take her bra completely off. I was focusing on the nipples, and therefore did not recognize IGT of the lower, inner lobes of her breasts, the tell-tale wider flat space between her breasts being quite well hidden behind the center panel of her nursing bra. (Her problem that had caused the nipple pain with the first child went on to occur with each subsequent birth as well, and was solved with one or two prompt craniosacral treatments to each of the babies as a newborn. She had fast, unmedicated births)
When I did recognize IGT at a home visit at 5 days postpartum with her second child, and explained it to her, she seemed thankful for an explanation of low supply, and happy to go ahead as best she could. She decided to breastfeed directly as much as possible, pump off and on between feedings and supplement with EBM or AIM at breast when necessary, using a home-made supplementer, for 18 months.
Several years later, she called me when she was 3 months pregnant with her third child to report that she had been experiencing increased firmness, tenderness and size in her breasts during the first trimester, which I attributed to all the suckling with and without supplementer + pumping with her second child. (I did not meet her personally to examine precisely in which quadrant(s) she was experiencing the extra size/growth, so I thought it was probable that she was experiencing still more growth in other quadrants and not in the lower, inside ones???) She went on to breastfeed that third child exclusively without supplements till normal time for solids, continuing to breastfeed till self-weaning at 22 months,
I have no idea exactly in which part of the TDLU (terminal ductal lobular units) of the breast that most prolactin receptor sites are actually built up. From descriptions, I visualize that involution of alveoli themselves, seems sort of like leaves on a tree, falling off at the end of a "season" and new ones reappearing (under stimulus of a new placenta) on the "branches" in the spring. (Complete involution and disappearance of alveoli at menopause. Fascinating subject.)
But somewhere in that total idea may be a source of hope for a mother who still arranges as much time at breast, even if it involves supplementing, so that perhaps with subsequent pregnancy(ies) more alveoli/binding sites may thus be stimulated to develop under the effect of hormones of the next new placenta.
Russo J, Russo IH Development of the Human Mammary Gland in: The Mammary Gland, Development, Regulation, and Function ed. by Neville MC, Daniels CW 1987 Plenum Press, NY. pp 67-93, Describing the breast as a whole: “This complex organ therefore has to be described in its anatomy, histology, ultrastructure, physiology, or response to hormones not as a static picture, but as a dynamic phenomenon in which each phase is transitory and heavily dependent on the age at which it is studied, and the specific conditions of the host . . . the development of the mammary gland has to be evaluated based on the architecture of the organ at each given period of time for each individual woman.”
K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC Dayton OH
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