This is my first posting, so let me tell you a little about myself. I am a
Certified Lactation Counselor and Doula (DONA cert. requirements nearly
completed). I have three children: 9,4,2 (who nursed 3y 3m, 2.5y, and
still, respectively). I expect to sit for the IBCLC next year and will be
going back to school to get my bachelors in Maternal and Child Health:
Lactation Consulting through the Healthy Children 2000 Project/The Union
Institute partnership. I am very excited with my new direction!
My question is about supernumerary tissue. Here's the story: I had a mom
see me with her 6 week old infant who is a strong and frequent nurser. This
is her third child and she has never had any unusual circumstances before.
She has become quite concerned about a lump that appears under her areola
(resembling a galactocele) that becomes tender and increases in size with
each let down. I observed this with a couple of feedings. She had feared
a plugged duct and developing mastitis, and had been aggressively pumping
after each feeding to drain this. This has been successful, however it
takes some time (up to half an hour) to pump until it becomes soft and then
is quite tender. The baby has terrific positioning and latch, however the
lower lip in the cradle position (or the upper lip in the football position)
naturally is positioned over the edge of the swelling. Now for the
interesting part! When the mom gingerly yet firmly pressed down on the
swelling, milk dripped from an opening in the areola. She reports that she
has seen this happen from several different areolar sites also. The sites
had appeared to me to be the usual Montgomery glands until I saw milk
beading up and dripping from this one! I feel that her right areola
involves supernumerary tissue that was previously dormant. With the
aggressive nursing of the new baby it has been stimulated to produce milk.
However, due to the position of the ductal opening, the infant's correct
latch can not accommodate this duct causing swelling, irritation and
tenderness. Further, the pumping following each feed may be exacerbating
the swelling and irritation. I recommended her turning down the suction on
her pump to reduce traumatizing the area while she's pumping and manually
express to comfort, and she has had great success with this. My question is
this: are there any documented cases or research out there that I can pass
on to her and her doctors to inform them of such phenomena? She needs
reassurance as she has been inundated with cancer stories recently and went
to the Wendy Logan clinic for a mammogram and aspiration of this swelling.
They drained 2 1/2 ounces from the site and were never informed that she
leaks from the areola leaving them with only with the thought that this is a
galactocele. With 3 young girls all under the age of 5 and the fear of
cancer and/or mastitis, this mom needs some serious reassurance. She also
has to go back to France Nov 2. Fast replies please!! Thank you so much in
advance.
Shelley W. Choate, CLC, Doula
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