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Date: | Wed, 18 Jul 2007 12:07:41 -0700 |
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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
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