Lactation

September 15, 2011

Producing milk follows pregnancy and birth as inevitably and naturally as pregnancy follows conception. It is a normal function in all mammals and each species produces milk, which is the best specific food for its own newborn.

During pregnancy, under the influence of hormones such as estrogen and progesterone, the female breast undergoes noticeable changes. The blood vessels on the surface of the breast increase in size and become more visible. The nipple enlarges and the area around it, the areola, becomes larger and often darker. Small nodules often appear on the areola. The breast also becomes larger due to the increase in the milk glands and ducts that will carry the milk to the nipple after the baby is born. Even before birth, the milk glands will start to produce a clear yellow substance called colostrum. These changes often start early in pregnancy and will continue until after delivery when true milk production will start.

About 3 days after the birth of the baby, the mother will feel her breast filling up. For some, it is quite sudden, for others, it is more gradual. The baby will have been sucking at the breast regularly since birth and will have received colostrum, which is very rich and nutritious. A hormone called prolactin regulates the production of milk. It occurs any time after the birth. A different hormone called oxytocin produces the ejection of milk. Oxytocin is stimulated by the baby sucking at the breast. The release of oxytocin is also dependent on the relaxation of the mother. If there is too much tension, such as that caused by pain, fatigue, depression, or nervousness, the production of oxytocin will be inhibited and the milk will not let down as easily.

Breast milk contains a combination of protein, fat, enzymes (help in digestion), immunoglobulins (provide immunity from some diseases), leukocytes (help fight infections), hormones, and growth factors.

As well as being easily digestible and perfectly suited for the human infant (just as cow’s milk is perfectly suited to the calf), breast milk is known to prevent infections in the infant. Breast-fed babies have fewer episodes of diarrhea, ear infections, and gastrointestinal problems.

The amount of breast milk needed by a baby is regulated by how much and how frequently the baby sucks at the breast. It is a wonderfully well-tuned mechanism of supply and demand. The more often the baby empties the breast, the more signals will be sent to the pituitary gland to increase production of prolactin and hence milk.

Just as immunity is passed from the mother through the breast milk, various food substances, infections, and medications can be transmitted. under certain circumstances, such as when the mother has hepatitis, tuberculosis, or is HIV positive, it may be preferable for a baby to be formula fed. Medications taken by the mother will also be secreted in her milk. This is usually in very small amounts, but this is why it is very important to weigh carefully the need to take any medications during breast-feeding, and to always consult your midwife or doctor before taking any medications. It is important to remind whoever is prescribing a medication that the mother is breast-feeding.

When breast-feeding a baby, it is ideal to offer the breast whenever the baby appears to be hungry. If this in done consistently, the quantity of milk produced will equal what the baby needs. A breast-fed baby should have several wet diapers a day, and frequent bowel movements. Most babies after the first couple of days of life will breast-feed every 1-3 hours. If this does not occur, the new mother can call for assistance. The hospital where she had her baby will often have a lactation consultant, or she can contact her local chapter of La Leche League. Breast-feeding can be continued as long as both the mother and the baby feel comfortable doing so. Solid food is usually introduced between 4 and 6 months. The baby’s pediatrician can assist the mother in making these choices.

Stopping breast-feeding is called weaning. It is best done very gradually in order to minimize discomfort of full (engorged) breasts and avoid mastitis, which is an infection of the breasts, which can occur when breasts become engorged.

Pregnant women should be strongly encouraged to breast-feed their babies. It is a very healthy and satisfying experience for both and helps create a strong bond between mother and child.

SEE ALSO: Breast-feeding, Pregnancy

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