Possible IGT?

[Squashpocket]

I am currently 24 weeks pregnant with DC2 and am starting to panic about breastfeeding again. My DS1 was born 18 months ago and we had a really rubbish time trying to establish BF. My worry is that I may have a breast abnormality e.g. insufficient glandular tissue and I'm on the road to BF failure again.

My reasons for thinking IGT are:

General feeling even pre-pregnancy that that my breasts are 'unusual' in shape. They're not 'tubular' as per the usual description of IGT, but they're not round - more pointy/lacking in fullness?

Not much change in breast size during pregnancy - maybe half a cup size bigger, but was also a lot fatter by the end of pregnancy so could have been that(!)

Sore nipples in early pregnancy, but no breast tenderness (never had any changes in breasts with periods either)

Comment from midwife at the hospital post-birth that I might have trouble with latching due to the shape of my breasts

Breasts did get a little bigger after birth, but mainly just went a really weird shape (again more pointy)

No feeling of milk 'coming in' or engorgement - just slightly warm and tingly feeling in breasts/nipples for a couple of minutes on day 3

No feeling of 'let down'

No pain or engorgement when stopping BF or if DS hadn't fed for a while

Never able to express more than 5ml in total per breast, (even when taking domperidone, which did help - was expressing 1-2ml before)

We ended up back in hospital on day 4 with DS due to 11% weight loss and were advised to start formula top ups immediately as DS was badly dehydrated. I continued to
BF/formula feed/pump on rotation every 3 hours for the next 12 weeks, but I never seemed to make any significant amounts of milk. Once I gave up pumping and BF,
the amount of formula top ups stayed the same, so I assume he wasn't getting much milk, if any, from me.

I saw a breastfeeding counsellor at 6 weeks, but she wasn't very helpful - just said 'keep putting him to the breast' and made me cry (in fairness everything made me cry at this point!).

Can someone with experience in this area tell me if this sounds like a lost cause? Could anyone advise what I should do to give myself the best shot at successfully breastfeeding this time?

[loveisanopensore]

I think I have it.
My left breast is larger than right, no breast changes during pregnancy and I never got engorged after childbirth.
With my first baby we had a terrible time, 11% weight loss, top ups, pumping where the milk barely covered the bottom of the bottle. I hired a lactation consultant at 6 weeks when she wasn't gaining any weight and the advise from the hospital was impossible to follow on contradicted a lot of what I'd learned about successfully establishing breastfeeding. We then used an SNS for tops up till around 6 months when I could phase them out as baby was happy and gaining weight on solids and breast milk.
Second pregnancy read 'Making More Milk' and was bit better prepared. I hand expressed colostrum in the final weeks and took a goats rue supplement. Only a 4% weight loss and back up to birth weight by day 10. After a few weeks we did have to supplement as her weight gain was slow but not as much as the first time and we stopped when she was on solids at 25 weeks.

I would recommend talking to a lactation consultant or breastfeeding councillor. Doctors don't seem to know much about breastfeeding and even my midwife was sceptical when I said I thought I had IGT.

[Squashpocket]

Thank you so much for replying. Hearing that you were able to breastfeed your second gives me so much hope.

I have noticed more breast changes during this pregnancy. They're definitely a bit bigger this time and a bit more tender, so hoping it's a good sign.

I've contacted a lactation consultant and thinking of going back to the gp that prescribed the domperidone last time.

I also found the nurses, health visitors and drs I saw last time quite unhelpful. One hv told me to just stop giving my son formula top ups cold turkey and go to bed with him for a weekend. He was 3 months old and on 700ml of formula per day at this point. Is this normal advice?! It sounds absolutely crazy to me

[loveisanopensore]

That seems dangerous to be honest.
I did follow this method from Kellymom as advised by my lactation consultant; kellymom.com/ages/newborn/nb-challenges/decrease-formula/
I hope it goes well for you. I found it heartbreaking when i couldn't EBF, be kind to yourself. Xx

[bigmamapeach]

"One hv told me to just stop giving my son formula top ups cold turkey and go to bed with him for a weekend. He was 3 months old and on 700ml of formula per day at this point. Is this normal advice?! It sounds absolutely crazy to me"

Yes, absolutely that sounds pretty risky. I don't think anyone on the internet (even an HCP, and they should not be giving individuals advice on the internet anyway) will be able to say if exclusive bf is realistic for you this time around or no. Even if you have IGT, some bf may be possible and even ebf apparently has been reported for some women thought to have IGT.

Not sure what to suggest but be aware if it is IGT, ebf is less likely so supplementing may be needed. But perhaps knowing that ahead may make it easier for you.

TBH, I'm not sure there is enough science there to give individual predictions on what is possible/probable. The science of understanding milk supply and why some women don't make enough even when the conditions are right, is minimal to absent.

The main things to maximise success, if you can, skin to skin after birth; try to feed 8-12 times per 24 hour after birth and continuing until baby settles into own rhythm; getting in person help with attachment and positioning; responsive feeding; know what to expect with weight gain and nappies first 2 weeks. Good luck. All the best!

[nicoletheo]

I have just been told I might have it – I am pregnant with my second. I went to a midwife and BF counsellor for an Ante-Natal appointment and she examined me and said she thought I had it and would have trouble EBF-ing again. Worth going to see someone who can tell you for peace of mind. I think I'll have to combination feed from birth. Good luck x