I don't think there's enough evidence to make a new category of immature 
glandular tissue, I think it all falls under mammary hypoplasia 
somewhere in the life cycle. Insufficient glandular tissue is a 
developmental problem of the breast, in that proliferation of the future 
milk making tissue did not happen properly. This can happen anywhere 
along the chain from the earliest mammary pit during early fetal 
development to failure of proliferation during pregnancy, to failure of 
onset of copious milk secretion. There are different windows of 
opportunity involved and different hormones, and Lisa Marasco has made 
teasing this all out her life's work.

If we could identify when the problem started, we might be able to 
intervene. In the meantime, things to explore include: breast changes 
during pregnancy, PCOS and other insulin metabolism issues, 
hypothyroidism, and timely removal of FIL right after birth. 
Progesterone deficiency and testosterone overload have all been shown to 
impact breast development and lactogenesis. Pushing lots of stimulation 
to increase prolactin levels may help after birth (remember the great 
article that Huggins and Petok did in Clinical Issues in Human Lactation 
  on the topic) and fixing metabolic issues may help as well (metformin 
for PCOS, thyroid replacement for hypothyroidism).

If the breasts you are looking at seem "inactive", that might point to 
problems in stimulation or later stages of milk making tissue 
proliferation/maturation/activation. And remember that the fat tissue is 
not always affected, so that breasts with insufficient glandular tissue 
may look fairly normal, or may look globally hypoplastic (fat and 
glandular tissue both undeveloped).

Catherine Watson Genna, IBCLC  NYC

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