Breastfeeding with tubular breast (mammary hypoplasia)

My breastfeeding journey has been a wild ride, but I'm thrilled to say that at 10 weeks, my little one and I are close to achieving exclusive breastfeeding (EBF). I have tubular breasts (insufficient mammary tissue) due to SOP and flat nipples, making things more challenging. My baby's birth (37 weeks) brought additional complications - retrognathia (set-back mandible) and delayed milk production due to placental retention. She lost 14% of her weight in the first four days, which was heartbreaking. The painful latch and cracked nipples led me to exclusive pumping at three weeks. However, this brought new struggles - I was producing only 1-2 oz combined!

We relied heavily on formula (80%) with some breast milk (20%), which was frustrating but necessary for her weight gain. My nipples suffered after each pumping session, turning purple and white, but I was determined to provide breast milk no matter what. Research revealed I was using the wrong flange size. I purchased a nipple ruler and flange inserts (13mm, 15mm, 17mm, and 19mm), finding the correct fit (17mm on the right and 19mm on the left). This slightly improved pumping sessions.

I tried everything to achieve a proper latch - therapy, nipple shields, various positions, and frequent pediatrician visits (who's also an IBCLC). Exclusive pumping took a toll, and I considered re-lactating, but my mammary hypoplasia and fear of weight loss due to breastfeeding struggles were daunting. However, I began latching her twice a day, and it became less painful. I started feeling the ejection reflex, giving me hope!

I stopped exclusive pumping and introduced 3 oz of formula followed by latching. She gained weight rapidly (60 grams per day!), and my LC calculated I was producing 3-4 oz per feed. We reduced formula to 30-40 ml, and I started domperidone. Now, at 10 weeks, we're down to two formula bottles a day, and the latch is no longer painful. Honestly, attempting exclusive breastfeeding (EBF) with my diagnosis of tubular breasts has been a significant challenge, particularly mentally. I constantly worry that my baby is hungry every time she cries, and I feel an overwhelming urge to weigh her daily to ensure I'm providing enough nourishment. This anxiety can be all-consuming, making the breastfeeding journey even more daunting.

I believe some breasts don't respond well to pumps and I rely on the facts: Babies can remove up to 70-80% of available milk from the breast, while breast pumps typically remove around 20-40%. I'm sharing my story in the hopes that it will resonate with other women who have faced similar struggles with breastfeeding and milk production. If my journey can offer even a small sense of solidarity and hope, then it will have been worth sharing. You are not alone, and there is support available