Breastfeeding and Abnormalities of the Breast

There are many possible breast problems that breastfeeding mothers may face. Most breast issues are common and are not a cause for concern. But, some breast problems can be a sign of something more dangerous.

It's very important to understand and identify any issues that you run into with your breasts as soon as possible. By quickly taking care of breast problems when they arise, you can prevent them from developing into more complicated issues that can interfere with breastfeeding your baby and your future health.

Breast Asymmetry

There are typically three situations when breastfeeding women may have breast asymmetry or uneven breasts: 

Slight Difference in Breast Size

One breast may be slightly larger than the other, but it is not causing any concern. Slightly uneven breasts are normal when you're breastfeeding. It's often the result of your baby's breastfeeding pattern. The breast that you're going to start the next feeding on will be fuller and larger than the breast you used to start the last feeding.

Large Difference in Breast Size

One breast may be dramatically bigger than the other, and you may be making much more breast milk on that side. Sometimes a woman develops more milk-making tissue in one breast compared to the other. Or, if you've had breast surgery or breast cancer treatments on one breast, that breast may not make as much breast milk. When one breast doesn't make very much breast milk, but the other one does, the breasts will look uneven.

But, as long as your doctor says it's safe, and one breast can make breast milk, you can breastfeed your baby from that one side. It's also very possible to make a healthy supply of breast milk with just one breast. You'll just want to have the doctor monitor your child's weight and health. If all is well, there's no reason you can't breastfeed exclusively from just one side.

One Side Is Favored

Sometimes, one breast is bigger than the other because your baby has begun to favor one side or you are nursing more on one side than the other. You or your child can develop a breast preference for many reasons, such as nursing on one side due to comfort or focusing on your less dominant side to allow you type, cook, or do other things while feeding your baby.

Underdeveloped Breasts

If you have hypoplastic (underdeveloped) breasts, you were born with them. It's a breast issue where the glandular (milk-making) tissue in the breast does not fully develop. Underdeveloped breasts may be widely spaced, long, or thin, and you may not know that you have them until you get pregnant and have your baby. 

If your doctor tells you that you have insufficient glandular tissue in your breasts, you can still breastfeed. However, it might be tough to make enough breast milk so you may need to supplement your baby.

Breast Lumps

Your breastfeeding breasts can feel lumpy, especially when they're extra full. And, of course, it's natural to be nervous when you feel something in your breast. But, try to remember that most lumps that you feel when you're breastfeeding are not at all dangerous. 

There are three general categories that breast lumps fall into:

• Benign breast disease: Benign means not harmful. If you have a benign breast lump or lumps, you may feel swelling and tenderness, breast pain, or general lumpiness in your breast.
• Breast cancer: Only a small percent of breast lumps found in breastfeeding women turn out to be cancer. Breast cancer tends to show up as a painless lump on only one side. It's usually solid, hard and dense. The borders of the mass will be irregular, and it will be difficult to move around because it's attached to the surrounding breast tissue.
• Fibroadenoma: A fibroadenoma is a tumor in the breast tissue that is NOT cancer. It may feel like a single painless mass, but it is solid, firm, rubbery and elastic to the touch. This mass can move, and it may be round, oval, or made up of many lobes It is usually between one and three centimeters in size.

Other Possible Problems

Some of the common breast problems that can arise during breastfeeding include:

• Breast abscess: A breast abscess is a rare complication of a breast infection. It's a pocket of fluid that builds up in one area of the breast. However, there have been cases where women have had two in the same breast. Your doctor may have to remove the fluid with a needle, or you may need minor surgery. 
• Breast engorgement: Breast engorgement is one of the most common breastfeeding problems. It's caused by an increase of fluids in the breasts including breast milk, blood, and lymph. Engorgement can be painful and make it difficult for your baby to latch on and nurse. You can treat breast engorgement by breastfeeding very often, using a breast pump to relieve excessive pressure in breasts, placing cold compresses or cabbage leaves on your breasts for comfort, and taking an over-the-counter pain reliever such as Tylenol or Motrin if necessary.
• Galactoceles: A galactocele is a cyst filled with milk that's often the result of a blocked milk duct. A doctor can drain the galactocele by removing the milky fluid with a needle. 
• Mastitis: Mastitis is inflammation (swelling) of the breast tissue. It causes pain, swelling, and redness in the affected area on the breast. It can also cause flu-like symptoms. You may need to take an antibiotic if there's an infection present, so call your doctor. You can begin to recover from mastitis within 48 hours if you get plenty of rest, take your medication, and breastfeed very often.
• Nipple blanching: Nipple blanching is due to the sudden disruption of the blood flow to the nipples. The nipples turn white and may burn. Then, as the blood flow returns, the nipples gradually turn back to their original color. Nipple blanching can be very painful. To treat nipple blanching, make sure your baby is latching on well, try to prevent sore, cracked, and damaged nipples, and keep your breasts warm. 
• Plugged milk ducts: Plugged milk ducts are hard, tender, lumps that form in the milk ducts and block the flow of breast milk. Blocked ducts typically clear up in less than a day with frequent breastfeeding or pumping to remove breast milk from your breasts.

Breast Changes

If you see any of these breast changes, see your doctor for an examination. The early detection of potential breast problems is more likely to lead to successful treatment. 

• Change in the direction of the nipple: If the nipple looks as if it's being pulled in a different direction, it could be a sign of breast cancer.
• Dimple in the breast: A wide, shallow dimple in the breast is a sign of skin retraction. Dimpling can be caused by the shortening of the Cooper's ligaments, which may be a sign of inflammation or breast cancer.
• Fixation: Bend forward and examine your breasts for any unevenness, distortion, or decreased movement. With invasive breast cancer, fibrosis "fixes" or attaches the breast to the underlying muscles.
• Nipple retraction: The pulling back of the nipple may be either harmless (the majority of retractions) or malignant (occasionally associated with breast cancer). Make sure not to confuse retracted nipples with inverted nipples. 
• Prominent venous (vein) pattern: It's normal for breastfeeding women to have obvious veins on their breasts, especially when the breasts are overfull. However, if the veins are only protruding on one side, it can indicate certain types of breast tumors.

Abnormal Nipple Discharge

When you're breastfeeding there's normal nipple discharge:

• Blood: The idea of blood coming out of your nipples probably sounds frightening. But, when you're breastfeeding bloody discharge from the nipples can be completely normal. Rusty pipe syndrome and cracked, bleeding nipples are two breastfeeding issues that aren't dangerous but can cause red or rust-colored nipple discharge.  
• Breast milk: Breastmilk may be watery or thick, and it can be a variety of colors from clear to white to green.

Then, there's nipple discharge that might be more dangerous. It can include:

• Bloody discharge: Bloody discharge can be normal, but it could also be a sign that something is not right. Non-cancerous growths called intraductal papillomas can cause a watery, bloody discharge, and some types of breast cancer such as ductal carcinoma can also cause bloody nipple discharge. 
• Purulent discharge (pus): Thick, discolored fluid draining from the nipple could be a sign of an infection or mammary duct ectasia. 

Sometimes abnormal nipple discharge can look similar to normal nipple discharge, and it may be difficult to tell the difference between what's normal and what's not.

Skin Conditions

The skin on your breasts is also susceptible to a variety of problems including: 

• Eczema, psoriasis, and dermatitis: These skin conditions cause red, raised, patches on the skin that can be irritating, itchy, or painful. Although it may not be comfortable for you, these issues are not harmful to your baby so you can continue to breastfeed if you suffer from these conditions. 
• Herpes: The herpes virus on the breast can show up as small red bumps, fluid-filled blisters, or sores. You should not breastfeed if you have active herpes lesions on your breasts. Herpes is extremely dangerous for infants. Once your lesions dry up and go away, and you get the OK from your doctor, you can then resume breastfeeding.
• Poison ivy, oak, and sumac: The oils from these plants can cause an itchy, red rash with fluid-filled blisters. You should not breastfeed until you heal from these conditions. 
• Thrush: Thrush is a yeast infection. If you get thrush, you may see white patches on your skin or your nipple may look red or shiny. Thrush can also appear deep in the breast. You may not have any symptoms on the outside of the breast, but inside you may feel a sharp pain. You can continue to breastfeed if you have thrush, but you should seek immediate treatment for both you and your baby. 

A Word From Verywell

While you're breastfeeding, most of the breast issues that you'll encounter are common. Though they may be inconvenient or even painful, they're usually nothing to worry about. You can recognize any potential breast problems by learning about what's normal for your body and examining your breasts regularly.

If you notice anything that doesn't look or feel right to you, talk to your doctor right away. The sooner you can find out what's going on and get treatment, the better it is for you and your baby. Plus, it's always better to get things checked out and have them be nothing than to wait and find out you should have called your doctor sooner.