Columns / Discourse / May 1, 2019

Pillowtalk: No, that is not what milk ducts look like

Hi Pillowtalk,

I’ve been seeing that pic of milk ducts going around — is it real? Does everyone have them? How do you know if the lumps are cancer or just milk ducts? Also — I have inverted nipples, so could I still breastfeed?

 

Great questions! First — no, that’s not what mammary glands look like. Most likely, the image was an oversimplified representation of lobules, which are clusters of alveoli (the glands that produce breast milk). Milk ducts are the tubes that bring breast milk to the nipple. For those who haven’t seen the picture, imagine a cluster of thumb-sized bean-shaped pink glands with tubes attaching each to a central point (the nipple). It kind of looked like one of those quick-fill water balloon spigots that makes 100 balloons in 60 seconds. In reality, lobules are pretty messily arranged inside the breast tissue.

Everyone has mammary glands unless they are removed. Hormones related to ovulation and pregnancy (estrogen, progesterone, prolactin and oxytocin) are what begins milk production, and nipple stimulation helps move it along. Estrogen and progesterone are released by the placenta and increase the amount and size of glands in the breast. Prolactin starts the production of milk and oxytocin produced via nipple stimulation releases the milk to the milk ducts and out through the nipple, which is like a sponge of openings. With hormone therapy, some people assigned male at birth can breastfeed. Similarly, milk production can be prompted in people who are not pregnant.

Often, during pregnancy or breastfeeding, inverted nipples will “pop out” or be pulled out by the baby latching. Most likely, a doctor or other professional will work with you to help the baby latch on the first time, and they can help.

Once alveoli start to produce milk, they will continue to do so until understimulated. During consistent breastfeeding (every 4-6 hours), ovulation and menstruation halts, which can work as an effective contraceptive. Alternatively, many birth control options (like the depo shot and hormonal IUDs) do not affect breastfeeding.

Breast tissue and the glands inside it can be lumpy, and small tumors are sometimes impossible to feel under tissue. My best advice for breast self-exams is to do them regularly, and to notice when you feel a difference. Usually, cancer lumps are firmer, more fixed, and more irregularly shaped than the rest of breast tissue.

Unfortunately, breastfeeding or chestfeeding in people other than cis women is a fairly under-researched subject. Breast milk itself isn’t replicable in a lab, as it’s constantly shifting with the needs of the infant, based on the time of day, the health of the baby and the physical and emotional strain on the baby and the caretaker. For more information on breastfeeding, visit plannedparenthood.org, womenshealth.gov, scarleteen.com and other reputable sources; just not Twitter.

 

To suggest future Pillowtalk topics or to ask questions that will be answered anonymously, email sex.ed.answers@gmail.com.

 

Elleri Scriver

Tags:  breastfeeding Pillowtalk sex education

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