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 LONG

“FLAT”
TESTING A NIPPLE FOR
PROTRACTILITY
Smooth Musculature of Areola and Nipple in Cross
Section when Contracted to Make Nipple Erect.
 - yl r eht ae W morf dei fi do M
Sites of Supernumerary Nipples Along “Milk
Line”.

hW
 nekci H morf dei fi do M
Ramification of Lactiferous Ducts and
Mammary Tissue.
Anatomy of the Breast
Which is the correct attachment ?
A B
 B
A
 Signs of Good Attachment
1. More areola visible above baby’s mouth
2. Baby ‘s mouth wide open
3. Lower lip turned outwards
4. Chin close to the breast
5. Mother feels no pain
6. 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

Sore Nipples
Pain and damage to Fissures
nipples
Engorgement
Breastmilk not
removed effectively Baby unsatisfied,
wants to feed a lot
Apparent poor milk
supply Baby frustrated,
refuses to suckle
Breasts make less milk
Baby fails to gain weight
 Signs of Good
Positioning

1. baby’s body straight - not

bent or twisted
1. baby facing the breast, not flat
against mother
2. baby close to mother’s body
3. the baby’s 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 mother’s 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
When something touches Sucking Reflex
lips, baby opens mouth, When something
puts tongue down and touches palate, baby
forward sucks
Skill
Mother
learns to
position
baby Swallowing
Reflex
Baby learns When mouth fills
to take with milk, baby
breast swallows
 o r y
i st
H 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)
 NEW

OLD
• Ducts branch closer to
the nipple
• Conventionally
described lactiferous
ducts do not exist
• glandular tissue found
closer to nipple
• Subcutaneous fat is
minimal close to nipple
 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