Barbara Wilson-Clay writes

<As I understand it, researchers in Peter Hartmann's lab are calling into
question the notion of milk sinuses.  They seem to think that all the
ducts
expand and enlarge during letdown and that the bulb-like structures we've
described to mothers don't exist.>

Dianne Wiessinger first reported hearing this to me several years ago. I
deliberately traveled to Chicago to attend one of Dr. Hartmann's
presentations to ask him about this. He had changed his semantics to
something like "We are unable to identify the presence of milk sinuses on
ultrasound."

I agree with him that the common depiction of sinuses as occurring
somewhat like the spokes on a bicycle is not accurate. And I found one
excellent diagram, by Linzell, I believe, which demonstrates how the MER
does indeed cause the ducts to simultaneously shorten and expand in
diameter temporarily, in  order to propel the milk forward.

But the milk sinuses are identifiable as a separate entity under the
microscope and are illustrated by electron microscope photos in several
well known histology and surgical texts.

They are also clearly palpable in probably 98% of the mothers I have ever
seen in over 40 years of palpating sinuses as part of softening areolas
and observing for nipple function.

Don't give up on the presence of milk sinuses. The jury's not in yet.

Incidentally, I have heard that Dr. Hartmann is speaking at the annual
OLCA spring "Breastfest" this year.

Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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