a mother in a khaki shirt breastfeeds a baby in a light blue onesie

This blog could also be titled, “What no one tells you about breastfeeding” because there’s so much that’s a big surprise, that we’re completely unaware of when we get pregnant and give birth.  

Did you know that many women have breast tissue that actually extends deep into our underarms?  This breast tissue is known as the “Tail of Spence.”  We also have a cluster of lymph nodes, which are part of our immune system, located there, which can also swell.

In fact, many women noticed this swelling after their Covid vaccinations as their immune systems ramped up and their underarm lymph nodes enlarged.

The “Tail of Spence”

The breast tissue in the underarm, or “Tail of Spence,” was named after Scottish surgeon James Spence who wrote about an extension of breast tissue in the 1870s. About 6% -20% of women have this extra breast tissue called polymastia. 

During pregnancy, the level of estrogen and other hormones that help our bodies make milk is 10-20 times higher than it was before pregnancy. This strong mix of progesterone, estrogen, and prolactin triggers your milk ducts to expand. If this extra tissue in the armpit contains ducts it produces milk, which can lead to swelling and pain.  

This swelling can also cause another issue pregnant women deal with, swollen hands and Carpal Tunnel Syndrome.  

Have you noticed that your rings are tighter?  Yes, part of that is from extra fluid, but it’s also because swelling in the underarm creates just enough of a barrier, that it’s harder for blood and fluids from our hands and arms to return to the heart. The added fluids can compress nerves, especially in the narrow Carpal Tunnel area of the wrist, leading to more pain, difficulty holding on to objects and a tingling sensation. It’s all related. 

Lumps and swelling in the armpits during pregnancy or when a mom’s milk first comes in, are a sign of this extra breast tissue and may be the reason why you’re having pain in your hands. 

What can you do?

For breastfeeding moms, alternating warm and cool compresses is recommended for any underarm swelling areas as well as the whole breast. Expressing or even pumping breast milk can relieve painful pressure. 

If your hands are swollen, try to lie down and put them on pillows above your head to help blood and fluids return to the heart. 

For Carpal Tunnel syndrome, most women find the pain at night to be disruptive, Often, when we sleep, we curl up our hands and wrists, which create a very tight bend in our blood vessels making it harder for the blood to return to the heart, which increases the swelling even more.

You can remedy this by using a wrist splint to keep your wrist in a neutral position. These are available without a prescription at any pharmacy. Try wearing them at night to keep your wrist straight so that blood can easily return to the heart. If dropping objects, do talk to your health care provider. 

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