When a mother has a non-functioning breast, the first thing I do is look at
her fingers and arm on that side and ask if she has been diagnosed with
Poland's syndrome. As with any syndrome, there is a wide range - from few
effects through to skeletal ones on that side. My next question for Joanna's
client, since her breasts appear the same and the non-functioning one hasn't
become smaller through lack of production, would be: Did she have a breast
reconstruction, perhaps years ago? If skillfully done, this could mask lack
of chest wall development, as well as making the breast look the same as the
other.
Another possibility is that the ducts aren't patent. Mercifully this appears
rare and can happen in other mammals, too. I saw a cow with "blind" ducts,
years ago.
Is the supplementing for the mother's confidence?  If the other breast is
producing well, there normally shouldn't be any reason for supplementing, as
long as her baby is going to the breast according to need, i.e. no
restrictions. I have heard of at least four mothers with one non-functioning
breast have successfully breastfed twins on the one breast that does produce
milk. The twins I saw were bright, alert, and well-fleshed.
Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA 
Brisbane, Qld, Australia 
E: [log in to unmask] 
 
Joanna said:

Breasts look identical but one breast is making no more
than drops of milk.   She is supporting her infant on the functioning breast
with perhaps 4 oz formula daily.  She was referred to me by her pcp just in
case this unilateral production indicated some pathology in the
non-functioning breast.

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