Discharge from the nipples of men or boys may indicate a problem. Men that have discharge from their nipples are not typical. And discharge in non-pregnant women or women who are not breastfeeding may not cause concern. Discharge from the nipple does not occur in lactating women. Nipple discharge refers to any fluid that seeps out of the nipple of the breast. Nipple pain can also be caused by excessive friction of clothing against the nipple that causes a fissure. Herpes infection of the nipple is painful.
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If a nipple appears to be wedge-shaped, white and flattened, this may indicate that the attachment of the infant is not good and there is a potential of developing cracked nipples. One reason for the development of cracked and sore nipples is the incorrect latching-on of the infant to the nipple. In some instances, an ulcer will form on the nipple. Sore nipples that progress to cracked nipples is of concern since many women cease breastfeeding due to the pain. Nipple pain can be a disincentive for breastfeeding. If the baby increases nursing time at the nipple, the mammary glands respond to this stimulation by increasing milk production. After birth, the milk supply increases based upon the continuous and increasing stimulation of the nipple by the infant. This poor attachment can cause sore and cracked nipples and a reluctance of the mother to continue to breastfeed. The nipple is poorly stimulated when the baby latches on too close to the tip of the nipple. A poor latch results in insufficient nipple stimulation to create the let down reflex. A good attachment is when the bottom of the areola (the area around the nipple) is in the infant's mouth and the nipple is drawn back inside his or her mouth. Latching on refers to the infant fastening onto the nipple to breastfeed. This contraction of milk is called the "let-down reflex". The result of nipple stimulation by the infant helps to move breast milk out through the ducts and to the nipple. When the infant suckles or stimulates the nipple, oxytocin levels rise and small muscles in the breast contract, moving the milk through the milk ducts. These contractions are necessary to prevent post-partum haemorrhage. The strong uterine contractions that are caused by the stimulation of the mother's nipples help the uterus contract to clamp down the uterine arteries. Oxytocin release from the nipple stimulation of the infant causes the uterus to contract even after childbirth. Oxytocin is a hormone that increases during pregnancy and acts on the breast to help produce the milk-ejection reflex. During breastfeeding, nipple stimulation by an infant will stimulate the release of oxytocin from the hypothalamus. The physiological purpose of nipples is to deliver milk, produced in the female mammary glands during lactation, to an infant. Since nipples change throughout the life span in men and women, the anatomy of the nipple can change and this change may be expected and considered normal. The rest of the drainage leaves the nipple and breast through infroclavicular, pectoral, or parasternal nodes. 75% of the lymph is drained through the axillary lymph nodes located near the armpit. The axillary nodes are the apical axillary nodes, the lateral group and the anterior group. The lymphatic ducts that drain the nipple are the same for the breast. The venous vessels parallel the arteries. The arterial supply to the nipple and breast originates from the anterior intercostal branches of the internal thoracic (mammary) arteries lateral thoracic artery and thoracodorsal arteries. It marks the T4 (fourth thoracic vertebra) dermatome and rests over the approximate level of the diaphragm. The nipple is also used as an anatomical landmark. The dominant nerve supply to the nipple comes from the lateral cutaneous branches of fourth intercostal nerve. Mechanoreceptors are identified respectively by Type I slowly-adapting with multiple Merkel corpuscle end-organs and Type II slowly-adapting with single Ruffini corpuscle end-organs, as well as Type I rapidly-adapting with multiple Meissner corpuscle end-organs and Type II rapidly-adapting with single Pacinian corpuscle end-organs.
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The skin of the nipple is rich in a supply of special nerves that are sensitive to certain stimuli: these are slowly-adapting and rapidly-adapting cutaneous mechanoreceptors. Marsupials and eutherian mammals typically have an even number of nipples arranged bilaterally, from as few as 2 to as many as 19. In mammals, a nipple (also called mammary papilla or teat) is a small projection of skin containing the outlets for 15–20 lactiferous ducts arranged cylindrically around the tip.