Lactation

Lactation is the medical term for yielding of milk by the mammary glands which leads to breastfeeding. Human milkcontains the ideal amount of nutrients for the infant, and provides important protection from diseases through the mother'snatural defenses.

Early in a woman's pregnancy her milk-producing glands begin to prepare for her baby's arrival, and by the sixth monthof pregnancy the breasts are ready to produce milk. Immediately after the baby is born, the placenta is delivered. Thiscauses a hormone in the woman's body (prolactin) to activate the milk-producing glands. By the third to fifth day, thewoman's breasts fill with milk.

Then, as the baby continues to suck each day, nursing triggers the continuing production of milk. The baby's suckingstimulates nerve endings in the nipple, which signal the mother's pituitary gland to release oxytocin, a hormone thatcauses the mammary glands to release milk to the nursing baby. This is called the "let-down reflex." While the baby'ssucking is the primary stimulus for this reflex, a baby's cry, thoughts of the baby, or the sound of running water also maytrigger the response. Frequent nursing will lead to increased milk production.

Breast milk cannot be duplicated by commercial baby food formulas, although both contain protein, fat, andcarbohydrates. In particular, breast milk changes to meet the specific needs of a baby. The composition of breast milkchanges as the baby grows to meet the baby's changing needs. Most important, breast milk contains substances calledantibodies from the mother that can protect the child against illness and allergies. Antibodies are part of the body'snatural defense system against infections and other agents that can cause disease. Breast milk also helps a baby's ownimmune system mature faster. As a result, breast-fed babies have less diarrhea and fewer ear infections, rashes,allergies, and other medical problems than bottle-fed babies.

There are many other benefits to breast milk. Because it is easily digested, babies do not get constipated. Breast-fedbabies may have fewer speech impediments, and breastfeeding can improve cheekbone development and jaw alignment.

Breastfeeding is also good for the mother. The act of breastfeeding releases hormones that stimulate the uterus tocontract, helping it to return to normal size after delivery and reducing the risk of bleeding. The act of producing milk isthought to burn more calories, helping the mother to lose excess weight gained during pregnancy. However, research in2004 disputed this belief when body composition changes of lactation and non-lactating women were compared atintervals for six months postpartum. Breastfeeding may be related to a lower risk of breast cancer ovarian cancer, or cervical cancer . This benefit is stronger the younger a woman is when she breastfeeds; women who breastfeed beforeage 20 and nurse for at least six months have a 50% drop in the risk for breast cancer

In addition, breastfeeding does not involve any formulas, bottles and nipples, or sterilizing equipment. Breast milk is free,and saves money by eliminating the need to buy formula, bottles, and nipples. Because breast-fed babies are healthier,health care costs for breast-fed infants are lower.

Breastfeeding should begin as soon as possible after birth, and should continue every two to three hours. However, allbabies are different; some need to nurse almost constantly at first, while others can go much longer between feedings. Ababy should be fed at least 8-12 times in 24 hours. Because breast milk is easily digested, a baby may be hungry againas soon as one and one-half hours after the last meal.

Mothers should wear comfortable, loose, front-opening clothes and a good nursing bra. Mothers should find a comfortablechair with lots of pillows, supporting the arm and back. Feet should rest on a low footstool, with knees raised slightly. Thebaby should be level with the breast. The new mother may have to experiment with different ways of holding the babybefore finding one that is comfortable for both the mother and baby.

Some babies have no trouble breastfeeding, while others may need some assistance. Once the baby begins to suck, themother should make sure that the entire dark area around the nipple is in the baby's mouth. This will help stimulate milkflow, allowing the baby to get enough milk. It will also prevent nipple soreness.

Breastfeeding mothers will usually offer the baby both breasts at each feeding. Breastfeeding takes about 15-20 minuteson each side. After stopping the feeding on one side, the mother should burp the baby before beginning the feeding onthe other breast. If the baby falls asleep at the breast, the next feeding should begin with the breast that was not nursed.

Mothers can tell if the baby is getting enough milk by checking diapers; a baby who is wetting between four to sixdisposable diapers (six to eight cloth) and who has three or four bowel movements in 24 hours is getting enough milk.

New mothers may experience nursing problems, including:

• Engorged breasts. Breasts that are too full can prevent the baby from sucking. Expressing milk manually or with abreast pump can help.
• Sore nipples. In the early weeks nipples may become sore; a nipple shield can ease discomfort.
• Infection. Soreness and inflammation on the breast surface or a fever in the mother, may be an indication of breastinfection. Antibiotics and continued nursing on the affected side may solve the problem.

Treatment