Re: LC specialization: Specialists are those who know more and more about
less and less.
So I guess I at least have a special interest in the anatomy of the
nipple-areolar complex.
Deborah Tobin writes:
<my understanding is that the nipple/areolar complex is erectile tissue
so it
cannot toughen but can and does become more elastic with BF, as any tight
tissue or adhesions under the areolar tissue respond to the compression
and
lengthening of BF >
LN has had a discussion about erectile tissue before, and I seem to
remember that it was Kathy Dettwyler who explained it very clearly.
Nipple tissue is not what we generally speak of as erectile tissue.
Nipple erection works a lot like the erector muscles at the base of each
hair which can make our hair "stand on end". Erection of the nipple is
caused by contraction of circular and radial muscles of the nipple and
areola. Remember what happens when cold air, water, etc. hits them? (My
husband always used to remark that the men in their factory turned to
watch the women who were coming out of the air conditioned computer room
just to eyeball their nipples protruding under their clothing!)
Penile erection is related to temporary sequestering of blood in the
corpora cavernosa. And just consider what a cold shower does in that
situation!
I read in some plastic surgery literature that for the last 20 years or
so, plastic surgeons have been making use of the principle of "tissue
expansion" to expand, over at least a 2 week or longer time period, areas
of skin adjacent to areas needing repair. They cite the enlargement of
the abdominal wall, skin, etc. in pregnancy as the most familiar example
of the principle of tissue expansion.
An English physician wrote a letter to the editor in an American OB-GYN
journal a few years ago that this principle was behind the success he
had thus far obtained when he place bar-bell nipple jewelry deep beneath
the base of inverted nipples during pregnancy. I believe he stated that
the nipples would probably return pretty much to their inverted state
after cessation of nursing if the jewelry was removed. Some mothers kept
it in during lactation, others took it out.
I think it is probably this principle of tissue expansion at work in the
increasing elasticity of the nipple-areolar complex as the early weeks of
breastfeeding go by, and why they usually return close to their less
elastic normals after weanings.
I myself still favor offering a pregnant mother information and the
choice to decide whether to try prenatal nipple preparation measures at
37 weeks to increase circulation of estrogen (for elasticity) to those
tissues, and begin some tissue expansion to the walls of the milk
sinuses, as well as to condition the MER, teach her fingertip expression,
the general principle of off-center latch, and to acquaint her with the
handling of the breast as a feeding tool.
Just my $.02.
Jean
****************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio (still lazing around in Phoenix, due to meet Linda Pohl and
visit her Mesa store tomorrow.)
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