Today I am going to talk about a subject that may be new to you. We are going to talk about supernumerary nipples, also called accessory nipples, also called third nipple, also called triple nipple. They are often mistaken for moles or freckles or for skin tags. This can happen with males as well as females. You can have more than 1 extra nipple too! In fact, the medical literature states that more extra nipples are noted on males than females. Often times they go undetected until it makes itself known during puberty, menstruation or pregnancy. This usually happens when hormonal changes result in increased pigmentation. They use to be much lighter in color and during pregnancy get darker and more pronounced. They swell, become tender during cycles or pregnancy. Interestingly enough they even become swollen and have some milk dripping from them during the early days of lactation.

I know you are asking.. how does this happen? Well, breast development begins around week four of gestation. Their are two parallel lines of glandular tissue that we call the milk line. This extends from about the armpits, down the chest and abdomen all the way to the groin and ends near the groin at the inner sides of the thighs. Raise arms and lets draw an imaginary line….

Extra nipples or breast tissue is fairly common. It is a result of incomplete regression of the mammary ridge, also known as the milk line and happens the during development of the embryo before birth.

Breasts eventually develop from these lines of tissue and the remaining tissue regresses, which means that they go back to its former state. Occasionally this regression is incomplete and an extra nipple and/or breast tissue forms, usually along this milk line. This can happen in both males and females and while it usually is seen along the milk lines, it can happen in other parts of the body.

What happens during pregnancy and lactation. The hormonal changes during pregnancy and lactation can cause the accessory nipple to darken. Sometimes the area gets swollen and is irritated when it rubs against clothing. Not really knowing what it is and/or thinking it is like a skin tag, many people just cover it with a bandaid. Some it bothers enough to show it to their physician.

If it goes undetected or if it is noticeable but ignored, the accessory nipple may become highlighted during lactation when some leaking is noted. Any swelling or engorgement and any leaking of milk typically goes away shortly after the first week or so of lactation. I will have a picture of the milk line in the show notes, along with a link where you can learn more detailed information about extra nipples if you find it as fascinating as I do.

Looking a bit further into this subject, we can dissect this further and go even deeper and break this down into greater details. Now noone is expecting you to remember this, so a reminder that you can read my notes when you download this show, which is Episode # 158 and look into the Show notes.

When we are talking about extra nipples, we can think of it in terms of extra breast tissue. Their are several medical terms to describe this. Hypermastia or polymastia or ectopic breast tissue all mean the same thing and refers to the presence of accessory mammary tissue, in addition to the two main glands, which are the nipple and areola. I will list these variations of the same theme. I will also use just a few medical terms as I am keenly aware that along with moms who are newly pregnant and breastfeeding moms, I do have in my audience, quite a few professionals in this field as well as students of lactation and I know you will find this interesting.

1. breast tissue with a nipple and areola
2. breast tissue with a nipple but no areola
3. breast tissue without a nipple ) hyperadenia
4. nipple without glandular tissue ( hyperthelia or polythelia)
5. areola without nipple or glandular tissue
6. an ectopic milk duct that leaks milk through the skin without visible breast tissue or nipple

In my practice, while mothers may have had any of the above variations, what I have seen almost all of these, some many times however, I am not sure that I have ever seen an areola without nipple or glandular tissue. Which is not to say that moms I have met with have not ever had this. I am no looking much beyond the breast area, unless mom points out “something funny” in another part of her body. This is usually under the armpit as they can make things quite uncomfortable, so moms tend to point this out to me. Here is where I commonly see breast tissue without a nipple. Moms will frequently mention that this are became a bit swollen or sensitive or irritated during pregnancy, but they thought nothing of it. Now, when their volume of milk increases on Day 4 or 5, this whole area becomes very swollen, sometimes leaks milk and now moms are going to mention it. For instance here is what a few moms have said to me over the years:

I feel like I have a golf ball under my arms. – her breast tissue was quite engorged.
I feel like I have another breast, how can that be?
I am afraid something is very wrong and I am afraid to keep breastfeeding because it is not safe for my baby.
I have a grapefruit in my armpit and I cannot even put my arm down comfortably.

The most common place mom tend to go to in their minds is that they have cancer, they have a cyst. I tell you all of this because, while you will be getting this checked out by your HCP, I want to save you from initially freaking out, because if you are a new mother and your baby is a few days old and this lump was not there before, it is like an extra breast/nipple. If it leaks, this probably clinches the deal. So, while you are waiting for an appointment with your HCP, I hope to peel you off the ceiling and ease you anxiety!

What can you do in the meantime?

Ultimately, this extra breast tissue will not produce much milk, however, it can run from being sore to irritating to painful for moms. If this area is uncomfortable for her, I will usually tell moms to place some cold green cabbage directly over the area in their armpit after a breastfeeding. Replace the warm and usually soggy cabbage leaves with fresh ones after the next breastfeeding. It may take a few replacements over a day or two and usually that area will dry up and become more comfortable for mom. In other areas of her body, if it is irritating, it may help to put a band aid over the area, so it does not rub against the baby or an article of clothing. Typically the swelling will be resolved in a few days. Whether or not this extra breast and/or nipple tissue is bothersome to you or not, I encourage you to show this to your health care provider so they can confirm this is what you think it is OR suggest further evaluation if necessary.

I hope this has been quite educational and to a degree entertaining. Call me weird, however, I do love learning about all the different situations we see and the variations in breastfeeding and mothers anatomy. If this is something you have noticed on your body, please know that.

This actually is not that uncommon and there are many people walking around thinking they have a dimple along that milk line, when it actually is a third nipple.

Additional information:

http://emedicine.medscape.com/article/1117825-overview

https://www.buzzfeed.com/kimberleydadds/7-celebrities-who-are-in-the-triple-nipple-club?utm_term=.mbzERzeK1G#.sc7g5JdxNw