I went to the Long Beach presentation. They showed ultrasounds of letdowns
within the breast and of baby nursing & removing milk. They also showed
cadaver disections of breast ducts & glands spread out like a crocheted
doily. Segments of the tissue had been injected with different colored
waxes so it was easier to see the branching.

If you look at the current diagrams, you see small ducts from the nipples
widening out into "sinuses" within or at the edge of the areola. From
there, they branch out into the breast ending in milk glands.

What we saw instead was that the ducts begin branching wildly, immediately
at the base of the nipple. When there is a letdown, the entire length of
the ducts, from the glands down to the nipple, widen with the flow of milk.
They recorded something like 30 ml in a letdown. If the milk wasn't
removed, it seemed to surge backwards, like the tide going out again, and
the ducts shrank down as they emptied. The longer or more frequent the
lactation, the larger the ducts got during each letdown.

So, yes there is swelling of ducts within the areola, but that's not the
only place. In the ultrasound, you could see milk squirting out of the
nipple with each compression of baby's jaw and peristalsis of the tongue.
But it was all so rhythmic and controlled. The function is the same as we
have always believed. Baby does compress swollen milk ducts. It's the
structure within the breast that isn't quite what we thought it was: no
sinuses as specific, identifiable structures. It is clear that baby's
quick, light, initial suckling stimulates the letdown. Then he executes the
powerful compressions & long draughts to gulp the milk letdown.

The other interesting part was the volume of fats shown in the ultrasounds.
Full breast = little fat or foremilk. Emptied breast = lots of fat or
hindmilk. It was easy to see the little dollops of fat growing in numbers.
Measuring this fat volume was part of their research. The degree of fat
content was a predictor of how full or empty the breast was. That
information helped them determine how effectively (& quickly) their new
pump was emptying the breast.

Critique, please, from others who saw this presentation?

Phyllis

> I apologise for ressurecting such an old thread, but this info is
*exactly*
> why I subscribed.
>
> I was at a recent meeting and heard the information that the milk sinuses
> _do not exist_ passed along as fact.  Does anyone have the cite for this?
> Is the jury back in on this? I am utterly empty-handed on this... and
there
> is little I dislike more than having information that is out of date.
>
> Charlotte Millington

--- Phyllis Adamson, IBCLC
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