my very first professional client not only was a classic case  of primary milk
insufficiency, but had an extra breast in her armpit, just as described, and
with no visible nipple. upon gentle palpation it did seem that there was a
hard spot on the surface of the breast. she had had engorgement of this breast
during two previous pregnancies, which subsided after (early) weaning. i asked
dr. jack about this at the time and he confirmed that there is not always a
visible nipple.

carol brussel IBCLC
denver colorado