Milk Production and Ejection Physiology

How Breast Milk is Produced

    The breast consists partly of gland tissue and partly of
supporting tissue and fat. The gland tissue makes the milk, which moves,
towards the nipple along small ducts. Before the ducts reach the nipple, they
become wider and form lactiferous sinuses. 

    Around the nipple, there is a circle
of dark skin called the areola. Beneath the areola are the lactiferous sinuses.
When the baby begins to feed, two reflexes produce the milk in the ht quantity
and at the right time.

Mix Production Reflex-Prolactin

    Every time the baby sucks at the breast, she stimulates the nerve
endings in the nipple. These nerves carry messages to the anterior part of the
pituitary gland, which is situated at the base of the brain. The pituitary
gland produces a hormone called prolactin, which stimulates the breast to
secrete milk. More prolactin is produced at night.

    It is very important to understand the effect of sucking on milk
production. The more the baby sucks, the more milk will be produced by the
breasts. If she stops sucking completely or if she never starts, the breasts
stop making milk. The breasts will make extra milk in the case of the birth of
twins or a large hungry baby. 

    This is called the law of supply and demand: the
breasts supply as much milk as the baby demands. The best way to increase milk
supply is to encourage the baby to suck longer and more often. Any supplement
given to the child will reduce the sucking time and breast milk output will
fall. Hormones related to prolactin suppress ovulation and this helps birth spacing
also.

The Let-down Reflex, Milk Ejection Reflex or the Oxytocin Reflex

    Oxytocin is produced by the posterior part of the pituitary gland
as a result of the baby’s sucking. Oxytocin makes the muscle cells around the
alveoli contract and the milk is pushed down towards the nipple.

    Besides its role in breastfeeding, oxytocin makes the uterus
contract, which helps to deliver the placenta and stops bleeding after
delivery. Therefore, breastfeeding should be started as soon after delivery as
possible.

Helping Milk Ejection

    If a mother thinks lovingly of her baby or hears her cry, her
pituitary gland starts producing oxytocin. She feels a tingling sensation in
her breasts and some milk may flow out Her breasts are ready to feed the baby. 

    However, if she is worried, afraid, lacks confidence, is embarrassed about
breastfeeding or if she finds it painful, milk ejection will be hindered
Therefore, it is important to see that the nursing mother is comfortable,
relaxed and unhurried, and that breastfeeding is not painful.

How Milk
“Comes In”

    Breastfeeding
should be initiated soon after birth, For the first two r three after delivery,
the breasts feel empty and produce only small amounts of colostrum. After that
the breasts begin to feel full. This happens more quickly if the baby is
allowed to suck whenever she wants to from the time of birth. 

    Once the baby
starts sucking regularly, the breasts become soft again. This does not mean
that the milk has diminished. If the baby continues to suck whenever she is
hungry, there will be enough milk for her for six months or more.

The Sucking
Reflexes

    A healthy
full-term baby has three reflexes, which help her to feed.

• The Rooting
  Reflex
• The rooting
  reflex helps her to find the nipple If something touches the of her cheek and
  she is hungry, she opens her mouth and turns towards the source of the touch.
• The Sucking
  Reflex
• When something
  goes far enough into the baby’s mouth, she sucks it

The Swallowing
Reflex

    When the baby’s
mouth is full of milk, she swallows it. When a baby takes the nipple into her
mouth, she must also take in much of the areola so that she can press on the
lactiferous sinuses, which are under the areola Both the baby and her mother
have to learn how to do it. When a baby has had all the milk she wants from a
breast, she usually stops sucking and releases the nipple by herself. 

    She
should then be offered the other breast. Before doing so, the mother can hold
the baby against.her shoulder, so that she could burp. However, it is not
always necessary. If she does not release the nipple, the mother should put her
finger gently the baby’s mouth to break the suction. The baby should not be
pulled off the breast.