Can you specify? Does it look as if it is missing from a injury made  
by the baby or was it absent before she started to breastfeed?
Is it possible that this mom has Insufficient Glandular Development  
of the breasts?

The classic appearance of these breasts is long, thin and tube like,  
almost pointed at the areola and nipple, or it may appear pubescent:  
flat with little or no development of the nipple and areola. Or the  
breast appears to be composed of mostly areolar and nipple tissue.  
[Many women with these types of Insufficient Glandular Development  
may have breast augmentation surgery to give the breast or breasts a  
rounded appearance.]
However, it has been my experience that it can occur in one or more  
lobes of the breast, it can affect one or both breasts or it may only  
affect a portion of the breast(s). I have heard other LC's say that  
the nipple in that area isn't quite normal, though I haven't seen  
that myself.  Most of these moms can produce enough milk to get  
through the newborn period but as baby's needs increase the breast is  
unable to keep up.
In a visual breast exam the affected breast(s) appear flattened in  
some areas; the breast is not a rounded mound. Most commonly affected  
are the inner quadrants, making the breast look as if begins very  
close to or after the areola, Absence of tissue in the lower  
quadrants looks like the areola comes up from the chest wall with no  
"rounded look" against the chest. You can ask the mom to do a breast  
exam herself and report what she feels to you or get her permission  
to exam her.   Upon palpation, the breast feels "empty" in the areas  
where insufficient development has occurred. Little or no firm  
glandular tissue can be felt beneath the skin in affected areas.   
Definitive diagnosis can be made with ultra sound or mammography.
If this is the case, a feeding tube may be required to preserve  
breastfeeding and caloric intake.
Hope this helps,
Marie Davis, RN, IBCLC

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]