Breast Health 101: What is Normal and What is a Concern?

Breast Health 101: What is Normal and What is a Concern?


  1. Hair on/around nipples. Just like other skin surfaces on the body, the areola (dark    circle               around the nipple) contains hair follicles, so hair on the breast is considered normal. Shaving or     plucking could lead to inflection, so if the hair is bothersome, it's best to cut with a small scissors. 
  2. Inverted nipples. This occurs when the nipple retracts into the areola. Approximately 10-20 percent of women have inverted nipples on at least one breast. Inverted nipples can also cause challenges for women who'd like to breastfeed, but they can be overcome.
  3. Discharge from nipples. Fluid can be expressed from the nipple ducts of at least 40 percent of pre-menopausal women, 55 percent of women who've had a baby and about 75 percent of women who have lactated in the last two years. The fluid generally comes from more than one duct and varies in color, either white, dark green or even brown. This type of breast discharge caused by manual expression is normal.
    Spontaneous nipple discharge should be evaluated by your provider. This can be caused by a variety of situations, including medication, chronic breast stimulation, thyroid disease or other chronic medical conditions. Bloody or straw-colored (serous) breast discharge, especially from a single duct, should always be evaluated by a provider.
  4. Bumpy nipples. The areola contains numerous lubricating glands, called "Montgomery glands." These show up as areola bumps and are completely normal.
  5. Areola color and areola types. Areolas come in all different sizes and colors, mostly due to hereditary factors. Some women notice dark areolas or an increase in size with pregnancy and breastfeeding, but these features usually return to pre-pregnancy appearance after breastfeeding is complete.
  6. Skin changes and stretch marks. Breast skin can be affected by common skin problems, including itchy, dry patches from psoriasis or eczema. It's also possible to get a rash from anything that comes into contact with breast skin (contact dermatitis), like clothing. Stretch marks are also normal and appear as red spoke-like lines, which appear on the skin during times of rapid physical growth, such as puberty or pregnancy. Over time, the stretch marks often fade.
    Some skin changes are not normal, including ulcerations, swelling (edema), scaling, crusting, redness, dimpling or skin retraction. Palpable breast masses should be evaluated by a health care provider. Most breast masses are benign and not cancerous, but it's important to see a provider for an exam and to discuss family history.
  7. Breast shapes and sizes. Heredity is the most important factor in determining how big breasts will be. No creams, special exercises or clothing will permanently change breast size. It may change with weight loss/gain or during/after a pregnancy, but for the most part, the size of your breasts stays the same after puberty. It is not unusual to have uneven breasts, as well. Because of different breast sizes, women may find that during lactation, one breast may produce more milk than the other.

"It is normal to feel subconscious about the way our breasts look or feel, but we are all unique and special," Dr. Cowman says. "As women's health care providers, we would be happy to discuss any of your concerns. Sometimes, just hearing things are normal can be very reassuring."

Your Fresh Fruit Nutrition and Calorie Guide

Your Fresh Fruit Nutrition and Calorie Guide

Fresh fruit is a juicy, sweet treat, but getting the recommended two to three servings of fruit a day can be tough. UnityPoint Health Dietitian, Emma Rueth, MS, RDN, LDN, gives us this fresh fruit guide, including everything from calories in fruit and health benefits, to easy ways you can fit fruit into your daily routine.

Calories in an Apple

  • Calories per serving: About 70 calories, 0 grams protein, 19 grams carbohydrate, 3 grams fiber, 0 grams fat
  • Recommended serving size: 1 small apple (roughly 2 inches wide), half of a large apple (about 3 inches wide) or 1 cup sliced/chopped apple

“Apples are a good source of vitamins C and A, as well as potassium,” Rueth says. “Most of the vitamin C is stored in the skin, so eat the skin, too! Both the skin and the apple itself are great sources of insoluble and soluble fiber. Fiber can help to prevent cholesterol buildup in blood vessels, making apples a heart-healthy snack. One medium apple provides about 20 percent of your recommended daily fiber intake.

Calories in a Banana

  • Calories per serving: About 121 calories, 1 gram protein, 31 grams carbohydrate, 4 grams fiber, 0 grams fat
  • Recommended serving size: 1 cup sliced banana or 1 large banana (approximately 8 inches long)

“Bananas are a great source of potassium and magnesium, two of the electrolytes our bodies love. They are also a great source of vitamin C and vitamin B6 and copper. Bananas are an amazingly versatile fruit – you can freeze and blend them to make ice cream, you can cover them in chocolate for a dessert or top with peanut butter for a healthy breakfast. Bananas will thicken up your oatmeal and smoothies, too. As they ripen, the composition of bananas does change slightly. Less ripe bananas (the green ones) have more fiber, while more ripe bananas have slightly more fructose,” Rueth says.

Calories in Grapes

  • Calories per serving: About 100 calories, 1 gram protein, 27 grams carbohydrate, 1 grams fiber, 0 grams fat
  • Recommended serving size: 1 cup whole or cut-up grapes

“Grapes are a good source of copper and vitamin K. They also offer B vitamins and potassium. With or without the seeds, grapes can be part of healthy meal or snack. They also make a delicious dessert when frozen,” Rueth says.

Calories in an Orange

  • Calories per serving: About 85 calories, 2 grams protein, 21 grams carbohydrate, 4 grams fiber, 0 grams fat
  • Recommended serving size: 1 large orange (roughly 3 inches wide) or 1 cup orange sections

“Obviously, oranges are a great source of vitamin C, but there’s more! Oranges are a good source of copper, magnesium, potassium, calcium and B vitamins. Oranges are also a great source of the vitamin folate, which is essential for proper fetal neural tube development during pregnancy,” Rueth says.

Rueth also says while oranges and orange juice may look nutritionally equal, a whole orange is a healthier choice because of the natural fiber. She describes fiber as the body’s internal toothbrush that helps to control blood cholesterol, blood sugar and promotes general health.

Calories in a Peach

  • Calories per serving (fresh): About 60 calories, 1 gram protein, 14 grams carbohydrate, 2 grams fiber, 0 grams fat
  • Calories per serving (canned): About 110 calories, 1 gram protein, 29 grams carbohydrate, 3 grams fiber, 0 grams fat
  • Recommended serving size: 1 large peach (between 2 and 3 inches) or 1 cup sliced/diced peaches

“Peaches are a good source of vitamin C and E, B vitamins and potassium. While canned peaches are better than no peaches at all, the best canned option is always those fruits canned in 100 percent fruit juice. Draining the juice will help to reduce the calories, especially calories from sugar, of your serving of fruit but will allow you the benefits of those vitamins and minerals even when those fruits are not in season,” Rueth says.

Calories in Strawberries

  • Calories per serving: About 50 calories, 1 gram protein, 12 grams carbohydrate, 3 grams fiber, 0 grams fat
  • Recommended serving size: 1 cup whole, halved or sliced strawberries

“Strawberries are a great source of vitamin C and also offer folate, magnesium and potassium. Strawberries are also a fantastic source of fiber, which will help to keep you full and satiated after you eat them. This makes strawberries a perfect, lower-calorie dessert, even when topped with whipped cream,” Rueth says.

Calories in Watermelon

  • Calories per serving: About 45 calories, 1 gram protein, 12 grams carbohydrate, 1 grams fiber, 0 grams fat
  • Recommended serving size: 1 cup melon balls or 1 cup chopped/diced watermelon

“Watermelon is a great source of vitamin C. Watermelon also offers magnesium, potassium, vitamin A, B vitamins and copper,” Rueth says.

When choosing a watermelon in your grocery store or your local farmers market, look for a watermelon with a creamy yellow underside, and avoid those with dents or bruises. Then, knock on it. If it sounds hollow, that’s the one you want to buy.

Easy Ways to Eat More Fruit

Ready to fill your grocery cart? Rueth lists these quick ways to incorporate more fruit into your family’s meals:

  • Use frozen fruits. Buy frozen fruits and add to smoothies.
  • Serve with dip. Eat fruit and vegetables with your favorite dip.
  • Add to breakfast. Add fruit to cereal, yogurt or oatmeal.
  • Spruce up salads. Color your salads with any fruit or veggie.
  • Grill. Grill fruit for a unique, tasty twist.
  • Buy local. Visit a local farmers market for fresh produce.

For additional questions about fruit nutrition and ways to improve your diet, contact your UnityPoint Health primary care provider.

Other Topics from Our Experts:

Chocolate and Wine: Finding a Heart-Healthy Mix

Eat Well LiveWell: Overnight Oats

Sugar: A Sneaky Addiction