I think Winnie has described very well what happens in a lactating breast relative to milk sinuses. A lactating breast is dynamic, and static pictures or drawings in the past have placed milk sinuses under the areola. While they may not exist between feedings, when the?milk ejection reflex occurs, the ducts dilate and the graphic renderings?were?probably showing us dilated milk ducts. When I had the drawing of the side view of the lactating breast done for my book, "Breastfeeding Management for the Clinician: Using the Evidence," I looked at as many of the ultrasound photos and other pictures of the internal structures of the breast as I could. What I found in many of them was during the milk ejection reflex, what appeared as "milk sinuses" became apparent at the "Y"?junction of two milk ducts, frequently under the areola. These ducts looked like they had the ability to not only dilate but "stretch" or bulge in certain areas. I am sure we will continue to learn more and more about these structures-so maybe "milk sinuses" exist only during milk ejection and retreat between feedings.

Marsha Waalker, RN, IBCLC
Weston, MA



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