One more variable in a puzzling case of low milk supply -- the side that 
is producing less (just drops with pump, one-tenth of an ounce by the 
baby) has a more lightly pigmented areola -- not unusually pale, nothing 
that one would notice without comparing the breasts side by side (the 
usual arrangement!)  I was checking for any markers for hypoplasia, but 
the breasts are basically rounded, ample, closely spaced and not 
noticeably asymmetrical. 

The mother has a history of fibrocystic breasts, so perhaps some of what 
feels like firm, functional tissue is actually related to that.  (Does 
anyone have some good guidelines on distinguishing fibrocystic lumpiness 
and knots from useful ductwork?)  She had some cysts needle-aspirated a 
long time ago, and can't remember from which breast or exactly where the 
needle entered, so perhaps there's some scar tissue blocking ducts in 
the lower producing side.

But is the difference in pigmentation just a common-enough variation, or 
a marker for something more significant?  Even if it's nothing we can 
fix (and this wonderful mother is working hard on several angles of this 
problem) I'm curious if someone has a
:explanation, or speculation.

Margaret Wills, LLLL, IBCLC Maryland

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