Googling the phrase "nipple herniation" brings up numerous kinds of interesting information of various 
associated breast anatomy diagnoses, including tubular breast among others. 


I have cared for at least one adolescent mother (who came in to WIC at 5 days postpartum) who had 
tubular breasts. Although the shape of the breasts was very out of the ordinary, the shape of the 
areolae and the nipples in relation to the shape of the breasts never brought the idea of "herniation"  
to my mind. 


But of course, plastic surgeons and breast surgeons have more insight into inner anatomy from having 
actually viewed it 3-dimensionally during surgery and perhaps seen some such tissues post-mortem 
under a microscope at some time during their training. They are usually thinking of the surgery in terms 
of changing the appearance toward normalcy.  However, normalcy of physiological function is a different
matter. Much will depend on when the training took place, and the mutual insight of the physician and 
the mother in regard to possible desire to breastfeed in the future.


That mother I saw with tubular breasts (no surgery) did in fact produce a fair amount of milk in response 
to some limited pumping in the morning and in the evening after school and breastfeeding at night. The 
insistence of her support system on formula feeding made it hard to evaluate how much she could 
have produced if optimum breastfeeding management had been possible.


So then a lot of this current mother's progress may depend on whether there was also some deficiency 
in the amount of glandular tissue, and whether there was also some amount of breast implant due 
to some perceived lack of breast tissue. It's a little late to have the mom try getting a copy of her 
medical records regarding the breast surgery. 


But if anyone else ever does a prenatal breast exam and finds a condition involving breast surgery, 
they may then have the prenatal opportunity to get the surgical record and make an advance plan.
This way, there might be a little less guesswork in the postpartum period and the initiation of 
breastfeeding might be easier to assist, perhaps with a Lactaid or some other tubular 
supplementation system right from the beginning.


K. Jean Cotterman RNC-E, IBCLC
WIC  Volunteer LC  Dayton OH

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