Anatomy of the

Breast

Modified from Weatherly White RCA

EVOLUTION OF NIPPLE

Babies can breastfeed from almost all of them.

TYPES OF NIPPLE

AVERAGE

SHORT

INVERTED

FLAT

LONG

TESTING A NIPPLE FOR

PROTRACTILITY

Modified from Weatherly-White RCA

Sites of Supernumerary Nipples Along Milk

Line.

Modified from Hicken

Ramification of Lactiferous Ducts and

Mammary Tissue.

Anatomy of the Breast

Which is the correct attachment ?

A

Signs of Good Attachment

1.
2.
3.
4.
5.
6.

More areola visible above babys

mouth
Baby s mouth wide open
Lower lip turned outwards
Chin close to the breast
Mother feels no pain
Baby suckles effectively
a) a few quick initial call up sucks
b) then slow deep sucks, sometimes
pausing

CORRECT
ATTACHMENT
The tongue is under the
areola, with the tip of
the nipple touching the
hard palate.

Nipple Sucking
in which the nipple
is used as a teat

Process of
SUCKLING

Results of Poor Attachment

Pain and damage to
nipples

Sore Nipples
Fissures
Engorgement

Breastmilk not
removed effectively
Apparent poor milk
supply
Breasts make less
milk

Baby unsatisfied,
wants to feed a lot
Baby frustrated,
refuses to suckle
Baby fails to gain weight

Signs of Good
Positioning
1. babys body straight not bent or twisted
2. baby facing the breast, not flat
against mother
3. baby close to mothers body
4. the babys whole body supported

INDICATORS OF ADEQUATE BREAST

MILK INTAKE
(Early Postpartum Weeks)

1. Breasts full before feeding and softer

afterwards
2. Let-Down sensation in mothers breasts
3. Wet nappies /diapers:
6 or more /24 hours
4. Bowel movements: Several times /day

INDICATORS OF ADEQUATE BREAST MILK INTAKE

(Early Postpartum Weeks)

5. Contented baby between feeds.

6. Audible swallowing during a feeding
7. Average weight gain:
18 30 grams /day (3/4 1 oz. day)
125 210 grams /week (4 7 oz. per
week)

Reflexes in the baby

Rooting Reflex

Skill
Mother
learns to
position
baby
Baby learns
to take
breast

When something touches

lips, baby opens mouth,
puts tongue down and
forward

Sucking Reflex
When something
touches palate, baby
sucks

Swallowing
Reflex
When mouth fills
with milk, baby
swallows

y
r
o
t
s
Hi
Anatomy of the Breast
1840 Sir Astley Cooper
based on anatomical
dissection
Injection of colored wax
into milk ducts
inflated ducts
Intertwined roots of a tree

Dr. Donna Ramsay et al

used sophisticated
ultrasound technology
(Medela grant)

OLD

NEW

Other novel insights

External shape or size of breast is not
predictive of its internal anatomy nor its
lactation potential
Ratio of glandular to fat tissue is 2:1
in lactating breast (1:1 for non-lactating)
[ Breast surgery / enhancement / reduction ]

Other points to note :

65% of the glandular tissue is located in
a 30mm radius from the base of the
nipple.
The range of milk duct exiting from the
nipple is 4-18 ( do not act as reservoir
for milks)
The complex ductal network neither
arranged symmetrically nor in radial
pattern