Lesson 1, Topic 1
In Progress
The female breast is a mammary gland with a complicated system of blood vessels; milk ducts; adipose, fibrous, glandular, and lymphatic tissues. The breasts, hormones, and other organs work together to produce breast milk for a newborn. All healthcare workers should understand the anatomy of the breasts in order to effectively assistance new mothers in the process of breastfeeding. It is not uncommon for a mother who has small breasts to feel that she will have problems breastfeeding. But in breastfeeding, size really doesn't matter.The size of a woman's breasts is primarily determined by the amount of fat tissue. The amount of glandular tissue and milk storage capacity varies widely among women. Each breast has approximately 15 to 25 lobes of glandular tissue regardless of whether the breast is small or large.
As a result, the size of breasts does not affect breastfeeding and producing an appropriate amount of breast milk for a newborn. A woman with small breasts can produce as much milk and be as successful with breastfeeding as a woman with large breasts.The 15 to 25 lobes of glandular tissue in each breast are separated from each other by adipose and fibrous tissues that support the blood vessels and lymphatic system in the breast. Each lobe consists of 10 to 100 grape-like clusters of alveoli where the breast milk is produced. Ductules carry milk from the alveoli of the lobe, converging in a main lactiferous duct behind the nipple. Near the nipple the lactiferous duct widens in response to the ejection reflex and becomes smaller after the lobe is drained. These ducts terminate in 5 to 10 openings in the nipple like a sprinkler nozzle that allows the milk to squirt out in small little streams. https://www.youtube.com/watch?v=IS1XuKbJ0yg While breastfeeding is a natural act, it is also a learned behavior for both mother and baby. The baby is born with a rooting and a sucking reflex to help him feed but the rest is learned. The mother’s milk will come in after the baby is born but breastfeeding is LEARNED BEHAVIOR, a behavior that can be modeled at the hospital by caregivers before discharge. The most important and crucial part of successful breastfeeding is the latch. If a baby is not properly latched on to the mother's breast, feedings could be painful and unbearable to the mother. There are specific techniques and positions that promote successful latching that healthcare providers should be familiar with. When a good position and latch is obtained, breastfeeding can be a wonderful experience for both mother and baby. The new mother should be taught that the infant should have the nipple and about one-fourth of the areola in the mouth. Once the baby latches on properly, tongue movements along the teat put pressure on the lactiferous ducts, pushing the milk through the nipple.If the baby latches only onto the nipple, he will become frustrated because of the lack of milk, and the mother's nipples will become sore very quickly which will make her reluctant to nurse again. Lack of nursing due to sore nipples will decrease milk production and can result in engorged breasts. Epithelial cells line the inner sac of the breast's alveoli, where milk is produced. These cells mature about 16 weeks into the pregnancy but circulating hormones, including progesterone, dampen secretion of milk proteins until delivery. This process is the first stage of lactogenesis. The decline in progesterone levels at birth along with a lactogenic complex of prolactin, insulin, and cortisol initiates the second stage of lactogenesis. The outer cell layer of the alveoli consists of myoepithelial cells that contract with the release of oxytocin. The delivery of the placenta and nursing stimulate the release of oxytocin. The cell contractions push the milk from the alveoli through the ductal system to make it available to the nursing baby.During pregnancy, estrogen stimulates the growth and preparation of ducts for lactation. Progesterone prepares the alveoli for milk production. Prolactin levels increase during pregnancy and also help prepare the alveoli for lactation. The high levels of progesterone during pregnancy, however, prevent the release of prolactin from the anterior pituitary gland. The placenta produces high levels of estrogen and progesterone. With delivery of the placenta, the abrupt decrease in these hormones stimulates the release of prolactin that begins the synthesis and secretion of breast milk.After delivery, the production of prolactin continues in response to the baby's breastfeeding and removal of milk from the breast. If supplements are given to the baby or feedings are missed, milk production is affected. A supply-demand cycle is established. The lactating woman's breast produces the amount of milk consumed by the baby. When a baby breastfeeds, oxytocin is released from the mother's posterior pituitary gland. The oxytocin contracts the myoepithelial cells of the alveoli, causing the milk to be ejected through the ductile system. Oxytocin, therefore, is responsible for this "let-down" reflex. Breastfeeding mothers often describe a normal sensation of tingling and fullness in their breasts with the let-down reflex. Although nursing stimulates the reflex, other factors can also stimulate the reflex. For example, when a woman hears a baby cry, her breasts may start to leak. Oxytocin affects all smooth muscle in the body. Early in the postpartum period, oxytocin is responsible for the uterine contractions referred to as "afterpains." Uterine contractions cause uterine cramping and a slight increase in lochia. This process causes the uterus to return to its prepregnant state more rapidly than the uterus of a woman who does not breastfeed.When milk is not consistently and effectively removed, oxytocin uptake is suppressed and the ejection reflex is inhibited. Milk then accumulates in the breasts. Accumulation of milk in the breasts suppresses milk production and causes maternal breast engorgement. To establish a dependable milk supply, it is critical that the mother nurse frequently and that the duration of feeding is adequate for draining of the breasts. Once the new mother's milk supply is well established, prolactin production somewhat diminishes. The role of oxytocin becomes even more important, reinforcing the concept of supply and demand.Colostrum is an especially important substance for a newborn because it is rich in immunoglobulins, with secretory IgA as the major antibody and it is the ideal form of milk for the newborn within an hour after birth and in the early days of life. The antibodies in colostrum help protect the newborn from a variety of infections. Colostrum has a creamy yellow and thick appearance in comparison to breast milk, but colostrum has less fat than transitional breast milk. Colostrum, however, has more protein, fat-soluble vitamins, and minerals. Colostrum is important for the newborn and provides the following functions;There was a problem reporting this post.
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