LACTATION 101

Breastfeeding is the best source of nutrition for your baby. The World Health Organization recommends exclusively breastfeeding up to 6 months of age with continued breastfeeding along with appropriate complementary foods up to 2 years of age or beyond.

Breastmilk is a living fluid, ever- changing, feed to feed, to meet baby’s need. Breastmilk is made up many components but primarily of water. It contains carbohydrates, proteins and fat, and also contains minerals and vitamins.

Amazingly it contains hundreds of important substances that help protect and promote the baby’s immature immune system. These substances include antibodies, white blood cells, probiotics, hormones, growth factors, and has antibacterial properties.

Research shows that breastfeeding benefits both baby and mother. The longer the duration of feeding the longer the effects and benefits are for both mum and baby.

Breastfeeding helps to protect baby against

  • Respiratory infections
  • Ear infections
  • Digestive infections (gastroenteritis)
  • Obesity
  • Diabetes
  • Asthma and allergic disease and
  • Sudden infant death syndrome.

Also research clearly shows it has a positive effect on their long-term brain development

Health benefits for mum include lowering the risk of

  • Diabetes
  • Heart disease
  • Osteoporosis
  • Endometriosis
  • Cancer of the breast, uterus and ovaries.
  • Continued breastfeeding also delays ovulation and menstruation

BREAST CHANGES IN PREGNANCY

Breasts begin to grow as soon as you’re pregnant in preparation for breastfeeding your baby. These changes are caused by hormones of pregnancy surging through your body. Breast tenderness and nipple sensitivity are usually the first signs of pregnancy. During the second and third trimester the breast continues to change. The skin around your nipples (areolas) may also appear darker and larger. Small bumps appear on the areola called Montgomery glands. These glands produce an oily substance that cleanses, lubricates and protects your nipples from infection during breastfeeding. The substance smells like amniotic fluid, so your baby will instinctively move towards this familiar smell soon after birth and the darken areola acts as a visual guide to the nipple.

By the end of pregnancy, the milk-making tissues in your breasts, called mammary glands, have increased in size. This change can happen in mid or late-pregnancy, or even after you’ve given birth.

Breasts come in different shape and sizes. Breast size does not matter when it comes to Breastfeeding. Breast size is just dependent upon fatty tissue in the breast. Your Breast contains glandular tissue and that’s what produces milk.

Mother’s nipples also come in many shapes and sizes. While most nipples protrude and are easy for baby to grasp, there are some variations in size and shape that may make it difficult for them to nurse successfully. Some flat, inverted, or very large nipples may cause your baby to find it hard to attach to the breast properly, so ensure you seek help in the early days.

The breast starts manufacturing milk as early as 16 weeks. This milk is called colostrum known as liquid gold a sicky yellow substance. Colostrum is produced in small amounts and it is all baby needs in the first few days. It is rich in white blood cells and antibodies which provide important immune protection. It also has a laxative effect helping new-borns pass the initial black meconium , and this helps reduce the risk of jaundice.

Within each mammary gland, different parts play a role:

· Alveoli: where breastmilk is produced. These clusters of small grape-like sacs are surrounded by tiny muscles that squeeze them to push milk through your breast to your baby. Alveoli develop during each pregnancy.

· Ductules: small, branching canals that carry milk from the alveoli to the main milk ducts.

· Milk DUCTS: these carry milk from the ductules straight to your baby via your nipple. Many  ducts grow during each pregnancy. The average is nine  in each breast

After your baby is born, and you have delivered the placenta, your levels of oestrogen and progesterone start to drop. This makes way for the hormone prolactin to be released from the pituitary gland in your brain. Prolactin tells your body to produce milk, Between Day 3-5 notice your breast growing heavier and the volume of milk increases dramatically. Feeding your baby often, and for as long as she wants, will help to soften your breasts. If your baby keeps taking milk from your breasts, your body will soon learn how much to make for your baby. This will stop your breasts from being over-full. Over the coming weeks your milk will change to mature milk. It will become thinner and whiter. Mature milk is tailored made to meet your baby’s growing needs changing in composition with each feed. It is also flavoured by mums’ diet.

MILK PRODUCING HORMONES

Prolactin is the main hormone needed to produce breast milk. The more often your baby breastfeeds, the more the prolactin levels in your bloodstream are boosted to produce milk. The levels are higher during the night and for this reason it is important to feed overnight. The hormone also helps establish the nurturing link between mother and baby which is important in establishing a bond.

Oxytocin is known as the Love Hormone. It causes the milk ejection reflex and it is carried in the blood where it acts directly on the alveoli to release milk. It also causes feeling of wellbeing, and relaxation in mum and baby.

HOW IS BREASTMILK MADE

As the baby nurses on the breast, nerve impulses are sent to the part of your brain’s pituitary gland to release the hormones Oxytocin and Prolactin.These hormones travel to the bloodstream to the milk producing cells called the alveoli.Prolactin acts upon these cells to produce milk. When oxytocin reaches your breast, it causes the tiny muscles around the alveoli to contract and squeeze, and release milk. Your milk moves along to the ducts just below the areola and when your baby feeds, she presses the milk from the ducts into her mouth. This is known as let-down. Some woman may experience tingling throbbing and warmth sensation with a let -down. This is normal and usually subsides in a few minutes and lessens with time.

HOW DO MY BREAST KNOW HOW MUCH MILK TO MAKE ?

While your baby is breastfeeding, messages are sent to the brain to make more milk to replace the milk baby is having. Your breasts then have a pre-order of milk ready for your baby’s next feed. The more often your baby breastfeeds, the more the prolactin levels in your bloodstream are boosted to produce milk. Over the weeks, milk production becomes less hormone- driven, but baby acts as the driving force. This is because of another hormone called feedback inhibitor of lactation (FIL). FIL tells each breast how much milk to produce.If your baby feeds from a breast often, the levels of FIL in that breast will be low. This acts as a signal for that breast to make more milk.If you feed less often the FIL will build up and less milk is produced and production slows down.Every mother has her own unique breast milk storage. Breastmilk storage capacity is the amount of milk the breast can store between feeds. It is not related to breast size. A mother with a small storage capacity will need to feed more than a mother with a larger capacity. However overall the breastmilk intake will be the same for both mothers.Lactating breast are never truly empty breastmilk is constantly been made so it is important to feed baby to early feeding cues.

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