Could it be that our notions of breast anatomy are based on a static image
from the stage in the peristaltic movement where the 'bolus' of milk is
under the areola?

Some years back we believed that an x-ray or two of a woman's pelvis could
tell us whether she could give birth normally or not.  Now we know that a
single, still picture leaves out an important part of the equation: the
mobility of the pelvic joints, and the expanded diameters in various
positions used by the woman in labor.  And imagine what we would think if
the only anatomical models of organs containing erectile tissue, showed them
filled with blood.  The first time we saw one taking a break, we would
probably think it needed medical treatment, or maybe even surgery.

Like Jean Cotterman, I have palpated what I thought were milk sinuses, and
maybe they were.  Once the edema surrounding them was reduced, milk
certainly dripped or ran or sprayed out of the pores draining them, whatever
the structures are.  I suspect that when overly distended, they resemble the
bulbs we are so familiar with from all the drawings.

Whatever they look like, it doesn't change a thing as far as how to latch
on, how to hand express, or how to pump are concerned.

And while we're at it, thanks so much to Pamela Morrison for her post on
technique for hand expression, Monday 5 August.  I have seldom felt so
validated: I think I am using the exact same technique.  It is described in
many books but the drawings are almost always bad.  Some illustrations I
have seen, make my breasts feel bruised just looking at them.  A video gets
it across much better, IMO, and a demonstration is far superior to either
drawings or film.

How about another kind of contest for the Guinness book: maximum volume hand
expressed from one breast in a set length of time, say 5 minutes?  And for
the person staffing the impartial booth with info on all the gadgets
available for milk removal, a t-shirt with the slogan 'Express yourself' and
a pair of strategically placed diagrams showing hand on breast, on the
front!

'Breast is best' has a short sequence, quite good, on hand expression, but
there is a Danish short film called 'hand milking' that is even better.  It
is in Danish but is so graphic that I think anyone could understand how to
do it even with no sound track.  I love the narrator's calm, low voice, and
the way the milk just pours out of those breasts.  I don't know where this
film can be obtained, you might try a google search for it.

Rachel Myr, midwife, IBCLC and fan of appropriate technology
Kristiansand, Norway

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