insufficient secretion of milk by the mammary gland. There are primary and secondary forms of hypogalactia.

Primary, or early, hypogalactia is rare; it appears immediately after parturition, usually in infantile primiparae with anomalous mammary development. It also appears after serious gestational toxicoses, wasting diseases, and surgical intervention in childbirth. Sometimes hypogalactia is the result of putting a premature or unwell infant to the breast too late. Complete absence of milk secretion from the breast (agalactia) in women post partum is extremely rare.

Secondary, or late, hypogalactia is usually associated with infrequent, irregular breast-feeding of the infant or incomplete drawing off of the milk residue after feeding. Causes may also include insufficient quantity and quality of nutrition, overexhaustion, psychic trauma, insufficient sleep, and lack of fresh air. If the infant is receiving too little milk it is restless, screams, and seldom urinates. The presence of hypogalactia is established by weighing the infant before and after feedings (several times a day), taking into account the quantity of milk drawn off after the breast-feeding.

Massage of the mammary glands is suggested for the prevention of hypogalactia. Inverted or flat nipples should be drawn out, through gauze, four or five times daily. The infant should be put to the breast six to 12 hours post partum and fed thereafter at regular and consistent intervals for 15-20 minutes, with an obligatory six-hour break.at night. All milk should be drawn off after feeding. Treatment for primary hypogalactia involves preparations that stimulate lactation and general restorative tonics. For secondary hypogalactia a proper regime, rational nutrition, vitamin therapy, physical therapy, and psychotherapy are recommended.