Is There an Association Between Breast Hypoplasia and Breastfeeding Outcomes? A Systematic Review

25 Years of Research in Human Lactation: From Discovery to Translation

“…There are other infant anomalies that typically affect the infant's ability to generate sufficient vacuum, which we have shown to be instrumental for effective milk removal [114]. Typically, infants that have difficulty creating vacuum such as those born preterm, infants with low tone, Down's syndrome, and cleft lip/plate have reduced milk removal [69,115,116]. In contrast, those infants of mothers experiencing pain during breastfeeding often apply very strong vacuums (Baseline vacuum: control: −52 mmHg, Pain: −95 mmHg; Peak vacuum: control: −171 mmHg; Pain: −238 mmHg) during breastfeeding and milk volume is reduced (Control: 78 mL; Pain: 55 mL) either due to altered tongue dynamics [117], the strong vacuum itself or reduction of the efficacy of milk removal due to diminished oxytocin release at ME reflex as a result of the pain [118].…”

“…Many factors are believed to impact milk production such as age, parity, and infant sex. Recent studies have shown no reduction of milk production with increasing maternal age with those between 15 and 37 years and [68] those between 23 and 42 years having an average milk production of 750 to 800 mL [69]. Similarly, there is no strong evidence yet of an increased milk production in women with higher parity, despite the demonstration in an animal model of epigenetic memory in mammary epithelial cells in subsequent lactations resulting in a more robust onset of lactation and volume [70].…”

Providing effective evidence based support for breastfeeding women in primary care

“…When a baby is consuming too little breast milk, the most likely reasons are restricted access to the breast (ie, not feeding often enough in response to early feeding cues, such as stirring, opening mouth, sucking fingers, rooting) and/or ineffective feeding causing inadequate milk transfer 35. If not resolved these will lead to reduced breast milk supply, so encourage mothers to spend time skin to skin with their baby to elicit instinctive behaviours and to notice early feeding cues.…”

Research Challenges and Considerations in Investigating Rare Exposures Using Breast Hypoplasia as an Example

“…Over the past 4 decades, the breastfeeding research conducted on breast hypoplasia and breastfeeding outcomes has been limited to purely descriptive case studies or series (Kam et al, 2021a). No large scale analytical studies on clinical samples or populations have been conducted to compare breastfeeding outcomes in individuals with hypoplastic breasts to those with normal anatomy.…”

“…Furthermore, Dodgson (2020) identifies that a "lactation case study" is suitably a fusion of content from health professional case reports and social science case studies. Published case studies reporting lactation outcomes for women with breast hypoplasia fit this description by containing contextual descriptions and specific details about the encountered lactation problems (Kam et al, 2021a).…”