Hypogalactia is insufficient milk production in the mammary gland of a new mother. Often, this underproduction is the cause of improper breastfeeding. In such a case, treatment consists of instruction in proper breastfeeding.
What is hypogalactia?
The terms hypogalactia, hypergalactia, and agalactia are used to describe abnormalities in milk production after pregnancy. Milk production and secretion are hormonally controlled and thus depend on the pituitary hormones prolactin and oxytocin. Both the formation of milk and the secretion of milk from the mammary glands are stimulated by the interaction between mother and child. Mechanoreceptors are located in the maternal breast. These receptors register sucking movements of the newborn. Registration of sucking touches stimulates hormonal secretion, which in turn causes milk production and eventually secretion. In hypogalactia, there is apparently not enough milk produced in the maternal breast to adequately breastfeed the infant. In contrast, the absolute absence of milk production is referred to as agalactia. Overproduction is present in hypergalactia.
Causes
The cause of hypogalactia is usually not organic. In the majority of cases, errors in breastfeeding are the real problem. In some circumstances, such errors can cause milk engorgement, for example, which gives the impression of hypogalactia. In only about five percent of all cases is hypogalactia due to an actual physiological problem. In most of these cases, the physiological cause of hypogalactia corresponds to a deficiency of the hormones oxytocin and prolactin. Both hormones are produced in the pituitary gland. A deficiency of these hormones occurs mainly when tumors have affected the pituitary gland. Most tumors in this context are benign tumors of the pituitary gland, which can disrupt the production of prolactin in particular, resulting in reduced production of milk in the maternal breast. A second physical cause of hypogalactia may be Sheehan syndrome. This syndrome corresponds to a postpartum obstetric complication that manifests as partial or global hypopituitarism and causes hypovolemic shock at delivery due to high blood loss. Because of the shock, there is decreased blood flow to the pituitary gland, which can result in necrosis of the tissue.
Symptoms, complaints, and signs
The individual symptoms of hypogalactia depend predominantly on the cause. The lack of milk usually becomes noticeable as soon as the infant is to be breastfed. The deficiency symptom due to milk stasis does not have to occur on both breasts, but can also be unilateral. If there is a physical cause such as Sheehan’s syndrome or a lack of hormone production, there is usually a milk deficiency bilaterally. Hypogalactia is usually only mentioned when the milk deficiency is present despite breastfeeding intervals. As accompanying symptoms, many of the affected mothers develop psychological problems in particular and feel insufficiently capable of fulfilling their role as mothers. Such psychological problems can exacerbate a lack of milk production. A vicious circle can develop. Hypogalactia is not usually associated with pain.
Diagnosis and course of the disease
To diagnose hypogalactia and, above all, to assess its cause, the physician mainly uses the medical history. For example, if birth complications such as Sheehan’s syndrome are known, the physician will be able to demonstrate the cause of hypogalactia within a short period of time. Imaging of the pituitary gland may be ordered to rule out causative tumor disease. If there is no necrosis or other change in the pituitary gland and the laboratory shows normal hormone levels in the mother’s blood, breastfeeding errors are probably responsible for the apparent milk deficiency. The prognosis of hypogalactia is usually considered extremely favorable, as the phenomenon is generally not pathological.
Complications
Hypogalactia usually results in definite symptoms, so treatment can be given quickly and early.In this case, the mother cannot produce enough milk for the newborn child, so that there is an undersupply of breast milk for the child. For the child itself, however, there are no further complications, since the nutrients can be absorbed in other ways. In many cases, however, the mother experiences psychological discomfort or depression and inferiority complexes. As a result, the quality of life is reduced, and the negative psychological state sometimes intensifies the complaints. However, the patients do not suffer from pain. In the worst case, hypogalactia can be caused by a tumor, which must be removed. Treatment of hypogalactia does not take place in every case. In most cases, the condition can be resolved by proper breastfeeding, so that the discomfort disappears quickly and no further complications occur. The child is then bottle-fed so that there is no nutrient deficiency. In case of psychological discomfort, treatment by a psychologist continues. The life expectancy of the mother and child is not affected.
When should you go to the doctor?
In the case of hypogalactia, a doctor must be consulted in any case. If the child is not adequately breastfed, it can cause severe damage and limitations in further development, which can also have a negative impact on the child’s life expectancy. For this reason, hypogalactia should always be treated. As a rule, the complaint is very easy for the mother to recognize due to insufficient production of breast milk. In this case, a hospital or a gynecologist should be consulted to avoid further complications and discomfort. Pain does not usually occur with hypogalactia. Furthermore, hypogalactia can also lead to psychological discomfort and upset. If these complaints occur, a visit to a psychologist is also highly advisable, as psychological complaints can also aggravate hypogalactia. In most cases, the disease can be treated and limited relatively well, so that there are no particular complications. In this case, the child can also be fed artificially.
Treatment and therapy
When hypogalactia has no underlying physical cause, therapy consists solely of instruction in appropriate breastfeeding. The mother is instructed not to give her infant bottle milk too often between breast feedings. Because the infant follows a different technique when sucking on the bottle than is necessary for the breast, his sucking ability is reduced during breastfeeding. This interaction is the most common cause of milk engorgement with apparent hypogalactia. Infrequent breastfeeding is also not recommended, since it is breastfeeding that stimulates maternal milk production in the first place. Mothers are therefore advised to adjust breastfeeding times to the infant’s needs. In addition, they should abstain from adapted milk during a growth phase, so that their breasts can get used to a higher secretion. If psychological stress inhibits milk production, hypogalactic patients receive additional psychotherapeutic care. Proper management of the stressors can be evaluated as a causal treatment of hypogalactia triggered in this way. Other therapeutic steps become necessary in case of physiologically induced hypogalactia. Tumors of the pituitary gland are surgically removed. In most cases, this causal treatment results in normal hormone production and hypogalactia regresses. In the case of a cause such as necrosis of the pituitary gland, surgery must be performed to remove the necrotic tissue. If the pituitary gland still secretes too few hormones, hormone replacement may be performed.
Prevention
Hypogalactia can be prevented in more than 90 percent of all cases by the mother of a newborn following breastfeeding recommendations.
Follow-up
Hypogalactia without a physical cause can be corrected with special instructions. This shows mothers how to breastfeed their baby properly. During the aftercare phase, they focus intensively on appropriate breastfeeding and the sound recommendations of physicians and midwives. Frequent alternation between breast feeds and bottle milk tends to be counterproductive. The infant’s sucking ability deteriorates due to the alternating techniques, which in turn has a negative effect on milk production. A visit to the doctor is usually not necessary.Often, it is also enough to get information on proper breastfeeding. The infant should always be breastfed when he wants it. In fact, more milk is formed when the child asks for it. That’s why mothers should also breastfeed their children at night, or at least let them suckle to establish close physical contact. Alternating the sides of the breast also has a beneficial effect on milk production and breastfeeding success. To stimulate the baby’s sucking ability, she should not have a pacifier in her mouth before breastfeeding. For longer aftercare in case of breastfeeding problems, there are special teas that stimulate milk production. Natural remedies from the drugstore can also help. Other stimulating measures include breast massages with oil and warm moist compresses.
What you can do yourself
In case of hypogalactia, it is not necessary to consult a doctor. Milk production can usually be stimulated by simple measures. First, it is important to breastfeed the baby as often and as long as he or she wants, because the more milk the baby demands, the more milk is produced. Therefore, breastfeeding should also be done at night, even if the baby only wants to suckle. In addition, both breasts should always be offered and the side of the breast should be changed several times. To ensure that the baby sucks vigorously, it should not be given a pacifier or bottle before breastfeeding. Special nursing teas additionally stimulate milk production. The same applies to malt beer and natural preparations from the drugstore. Normally, it is sufficient for the mother to drink a large glass of water before each breastfeeding. Massages also help. The most effective are gentle, circular breast massages with breastfeeding oil from the drugstore. Warm moist compresses can be applied to the breasts before breastfeeding. If these measures are combined with sufficient rest and plenty of physical contact with the baby, hypogalactia should subside quickly. Otherwise, a gynecologist must clarify the symptoms and prescribe appropriate treatment.
