[TiT] That S It Tuesday Issue 10 !!TOP!!
Many things can affect a baby's ability to suck and remove milk. Factors such as prematurity, jaundice, infection, heart disease, a mother's medicines and many others can affect a baby's ability to stay alert or coordinate the suck-swallow-breathe actions. Other mechanical issues that may play a role include tongue-tie or a cleft lip or cleft palate. These might directly interfere with a baby's ability to use the structures in the mouth for effective sucking.
[TiT] That s It Tuesday Issue 10
Sometimes the cause is obvious. Often it's not. But it's important to recognize the signs that a baby can't effectively remove milk during breastfeeding. Then the baby's healthcare provider can ensure there are no health or mechanical issues affecting feeding. And steps can be taken to fix the problem.
When a problem with latch-on or sucking continues beyond the first few days after birth, it can be discouraging. Most babies will learn to breastfeed effectively if they are given time. But it's important to work with the baby's healthcare provider and a certified lactation consultant (IBCLC) if a baby has trouble latching or sucking. Until the issue is fixed there are a few things you can do. These will help breastfeeding progress while you make sure your baby is getting enough to eat. Always talk with your baby's healthcare provider for more information:
Certain breastfeeding devices or alternative feeding methods may encourage effective sucking. Or they may give your baby added nutrition while he or she is learning to breastfeed. A certain device may be good for your situation. But every device also has disadvantages. To prevent problems, any breastfeeding device should be used with the guidance of a certified lactation consultant (IBCLC) or healthcare provider with advanced knowledge of breastfeeding. Devices that may be helpful in certain situations include:
Alternative feeding methods. There are also other alternative feeding methods. These will make sure that your baby gets enough food. But they are less likely to interfere with long-term breastfeeding. These include cup-feeding, syringe-feeding, spoon-feeding, or (eye) dropper-feeding. If using a bottle, bottle nipples with a slower flow rate are often preferred.
Don't throw away any breastfeeding device or an alternative feeding method because you did not like it or it did not work when first suggested. The device or method that did not help one day may work great the next.
Let your treatment team know if you develop a skin reaction. Most skin reactions are mild and should heal within three to four weeks of your last treatment, but some may need treating or monitoring more closely. For example, skin that has blistered or is peeling will take longer to heal.
Lymphoedema is swelling of the arm, hand, breast or chest area caused by a build-up of fluid in the surface tissues of the body. It can occur as a result of damage to the lymphatic system, for example because of surgery or radiotherapy to the lymph nodes under the arm and surrounding area.
Sometimes after treatment to the breast or chest wall area, part of the lung behind the treatment area can become inflamed. This may cause a dry cough or shortness of breath. It usually heals by itself over time. More rarely, hardening of the upper lung tissue can occur which can cause similar side effects.
A 22-year-old woman sought medical care for a lesion in the plantar region of her left foot, a well-formed nipple surrounded by areola and hair. Microscopic examination of the dermis showed hair follicles, eccrine glands, and sebaceous glands. Fat tissue was noted at the base of the lesion. Clinical and histopathologic findings were consistent with the diagnosis of supernumerary breast tissue, also known as pseudomamma. To our knowledge, this is the first report of supernumerary breast tissue on the foot.
The patient underwent an incisional biopsy of the lesion. Histologic findings were squamous epithelium with hyperkeratosis, epithelial hyperplasia without atypia, epithelial cytoplasmic vacuolation, and hyperpigmentation of the epidermal basal membrane. In the dermis there were hair follicles, eccrine glands, and sebaceous glands. Fibrosis and fat tissue were noted at the base of the lesion. No glandular tissue was identified.
Supernumerary breast tissue (SBT) is rarely found beyond the mammary line. However, the back [3], shoulder [4], face [5], and thigh [6] have been described as sites of SBT development. When glandular tissue is present, SBT may be affected by the same disease processes that occur in normally positioned breast tissue [7, 8, 9]. To our knowledge, this is the first report of SBT on the foot.
The study of SBT merits special attention because of some aspects. Initially, the patient seeks medical care for cosmetic reasons, expressing desire to have the lesion surgically removed, particularly if it is located in a visible area [5]. The presence of glandular tissue in the lesion should be investigated, because SBT is not exempt from the same diseases and physiologic processes that can affect normally positioned breasts, including the cyclical alterations induced by hormone action [2, 9]. Usually, the presence of glandular tissue is suggested after the onset of puberty, first childbirth, or lactation, at times when a woman may complain of an increase in size, pain and discomfort, as well as milk secretion [2]. In the current case, the patient was asymptomatic, even after pregnancy, suggesting a lack of glandular tissue. However, despite the clinical picture, it was necessary to perform a histologic examination to rule out the presence of glandular tissue.
Another aspect that should be kept in mind is the association between SBT and renal malformations [12, 13, 14]. Some authors describe a close association between both conditions, reporting that patients with SBT should be investigated for the presence of urinary tract malformations [13]. However, other authors found no evidence to support such an association, suggesting that routine investigation for renal anomalies is not indicated in patients with supernumerary nipple [15]. In the present case, ultrasonography of the urinary tract identified no malformations. In fact, there is still uncertainty as to the best approach in these patients.
Despite the difficulties in establishing relationships between SBT and other diseases, the identification of SBT should draw the attention of the physician to these possible associations and to the occurrence of malignancy, when breast glandular tissue is present. In cases in which it is clinically impossible to rule out the presence of breast glandular tissue, we believe that a histologic examination of the lesion is required.
A 22-year-old woman sought medical care for a lesion in the plantar region of her left foot, a well-formed nipple surrounded\n by areola and hair. Microscopic examination of the dermis showed hair follicles, eccrine glands, and sebaceous glands. Fat\n tissue was noted at the base of the lesion. Clinical and histopathologic findings were consistent with the diagnosis of supernumerary\n breast tissue, also known as pseudomamma. To our knowledge, this is the first report of supernumerary breast tissue on the\n foot.\n
The patient underwent an incisional biopsy of the lesion. Histologic findings were squamous epithelium with hyperkeratosis,\n epithelial hyperplasia without atypia, epithelial cytoplasmic vacuolation, and hyperpigmentation of the epidermal basal membrane.\n In the dermis there were hair follicles, eccrine glands, and sebaceous glands. Fibrosis and fat tissue were noted at the base\n of the lesion. No glandular tissue was identified.\n
Supernumerary breast tissue (SBT) is rarely found beyond the mammary line. However, the back [3], shoulder [4], face [5], and thigh [6] have been described as sites of SBT development. When glandular tissue is present, SBT may be affected by the same disease\n processes that occur in normally positioned breast tissue [7, 8, 9]. To our knowledge, this is the first report of SBT on the foot.\n
The study of SBT merits special attention because of some aspects. Initially, the patient seeks medical care for cosmetic\n reasons, expressing desire to have the lesion surgically removed, particularly if it is located in a visible area [5]. The presence of glandular tissue in the lesion should be investigated, because SBT is not exempt from the same diseases\n and physiologic processes that can affect normally positioned breasts, including the cyclical alterations induced by hormone\n action [2, 9]. Usually, the presence of glandular tissue is suggested after the onset of puberty, first childbirth, or lactation, at times\n when a woman may complain of an increase in size, pain and discomfort, as well as milk secretion [2]. In the current case, the patient was asymptomatic, even after pregnancy, suggesting a lack of glandular tissue. However,\n despite the clinical picture, it was necessary to perform a histologic examination to rule out the presence of glandular tissue.\n
Another aspect that should be kept in mind is the association between SBT and renal malformations [12, 13, 14]. Some authors describe a close association between both conditions, reporting that patients with SBT should be investigated\n for the presence of urinary tract malformations [13]. However, other authors found no evidence to support such an association, suggesting that routine investigation for renal\n anomalies is not indicated in patients with supernumerary nipple [15]. In the present case, ultrasonography of the urinary tract identified no malformations. In fact, there is still uncertainty\n as to the best approach in these patients.\n
Despite the difficulties in establishing relationships between SBT and other diseases, the identification of SBT should draw\n the attention of the physician to these possible associations and to the occurrence of malignancy, when breast glandular tissue\n is present. In cases in which it is clinically impossible to rule out the presence of breast glandular tissue, we believe\n that a histologic examination of the lesion is required.\n