I have seen three in the last year that fell into this category. One of them
is my next door neighbor who I felt really bad for. I was over there every
day. The baby was nursing like a champ every hour around the clock. I kept
thinking her milk supply would increase any minute. She felt some tingling on
day 5 and then nothing. She could pump drops. She had very flat breasts and
had felt no change during pregnancy. She continued to put baby to breast for
several weeks and bottle fed too. I suggested but didn't push the sns.

Another mom had breasts shaped more like what you described. I've heard them
called tubular. She pumped and finger fed and bottle fed and nursed for
comfort for several weeks.

Still another mom who I only had brief contact with described her breasts as
tubular and assymetrical.

These all occurred within a few months. I had never seen or personally heard
of any before this and now haven't since any since.

Marianne Nieffert calls this primary milk insufficiency. Now that I've seen
it I believe it exists. I know we need to be careful about ruling out other
causes, usually related to baby efficiency. I have also seen a couple of
cases where the mother had some edema, which slowed down milk production. One
of these also had latch-on difficulty and she cup fed for 3 days and baby
went back to breast. She had been pumping and as her edema was subsiding we
were hoping for milk production to kick in. Someone told her to drink a beer
and the next morning her milk was "in."

I also saw a mom recently whose breasts worried be because they had that
tubular shape and were assymmetrical. The baby is gaining fine, but nurses
constantly. Mom is a little sore because of the frequency and length of
feedings. Does this baby need to nurse this much because of a marginal lack
of glandular tissue? Are there varying degrees of this problem? Can they be
worked with and improved?

Sorry to be so long-winded. It is so nice to have someone to tell this stuff
to.

Marilee Woodworth IBCLC and LLL.