At the Medela "dog and pony show" before the ILCA Conferecnce, Peter
Hartman and his researchers discussed this question.  As the researcher
was doing an ultrasound (US) of a lactating mom's breast, she was saying
something like "Do you see any lactiferous sinuses?  We couldn't find
them either."  She then proceded to locate a duct and kept the US
transducer over that spot while baby started to nurse and again when a
mom started to pump.  As soon as baby began  gulping or there was
significantly more milk coming into the pump, the duct in question
expanded very noticably.  It struck me afterwards that in each case, the
transducer was placed over the areolar margin to pick out the duct that
would best show such expansion.  Now isn't that where lactiferous
sinuses are supposed to be?  Isn't their "function" (if they do exist)
to provide a reservoir where baby's jaws can compress and push a bolus
of milk toward the nipple?  OK, so maybe they aren't specific
identifiable structures, but if this is where it is easiest to show duct
filling, isn't that virtually the same thing?  Whether you call them
simply "ducts" or "sinuses" or "pwypyfs" (Places Where You Put Your
FingerS-in hand expressing) it seems to me it's the same thing!!!
IMNSHO, we need to keep the focus on how to help make breastfeeding
"work" well for moms and babies and not get so caught up in the
"science" aspect that we lose sight of the "art" of breastfeeding.
Don't get me wrong, I'm not saying we shouldn't research into how the
breasts function, but let's not let the pendulum swing completely over
to that end.

Winnie

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