breast milk

breast anatomy:

  • montgomery’s tubercles- secrete sebum to help lubricate nipple while breast feeding

  • nipple- sensitive, erectile structure that contains smooth muscle/ collagen/ elastic tissue. place where breast milk is expelled from

  • areola- darker area around nipple, gets darker in oregnancy to help baby locate nipple when breast feeding.

  • milk produced in alveoli

  • alveoli form clusters- lobules and lobules for lobes

  • milk transported via lactiferous duct.

alveolus:

  • lactocyte cell line inside of alveoli thhat produce milk

  • milk ejected from lumen of alveolus

  • surrounding capillaries allow componunts of blod to be secreated as well

  • myophelial cells contract due to oxytocin and push milk into duct

mammogenesis:

  • breast development happens at 4 weeks of fetus growth

  • by 12-16 weeks fetus developed nipple and areola.

  • in puberty progesterone and oestrogen levels increse and cause the growth of the alveoli/ nipple/ areolas and lactiferous ducts

week 6 pregnancy-

  • oestrogen cause lactiferous ducts to grow

  • progesterone and prolactin and human placenta lactogen (HPL) causes the alveoli to increase in size

  • common symptoms include breast tingling/ tenderness or heaviness.

week 12 pregnancy-

  • areola appear darker

  • montgomery tubercules begin to secrete sebum to protect nipple

week 16 pregnancy-

  • first breastmilk produced due to (HPL) and prolactin. procces called lactogenesis 1

at birth-

  • birth of placenta cause decrease in HPL and prolactin-inhibiting factors, cause breast to prep for ejection of breastmilk for baby- lactogenesis 2

  • when baby latches onto mum causes colostrum to be secreated.

postnatal 3-5 days-

  • colostrum develops into milk

  • often large increase in breast size

hormones involved:

  • prolactin- main hormone in milk production, triggered by touch, stimulate mothering behaviour

  • human placental lactogen (HPL)- released by placenta, encorage grpwth of breast tissue and milk production in pregnancy

  • oestrogen- promote growth and development of breast tissue, stops milk production in pregnancy

  • oxytocin- contracts myoepithelial cells to eject milk from alveoli

  • progesterone- promote growth and development of breast tissue growth, stop milk production in pregnancy

  • prolactin-inhibiting factor (PIF/ FIL)- stops release of prolactin

lactogenesis 1:

  • happen in week 16 of pregnancy

  • lactocytes start producing milk due to increase in hormones

  • happens regardless if woman wishes to breastfeed or not

  • full milk production suppressed by oestrogen and progesterone

lactogenesis 2:

  • happens post birth

  • prolactin-inhibiting factor (PIF)/ progesterone/ oestrogen/ human placental lactogen (HPL) all decrease after borth

  • prolactin receptors open when placenta delivered- cause milk production

  • skin-to-skin contact promote oxytocin- promote milk production

lactogenesis 3:

  • once baby born and start of breastfeeding milk production stop being only controlled by endocrine and nervous system

  • endocrine and nervous system share milk production

  • feedback inhibitor of lactation (FIL) secreted by lactocytes when lumin is full- stops milk production

  • if milk not emptied from breat FIL produce more milk

  • regular draining of breast- essential for breastfeeding succesfully

  • if fetal loss occur woman adviced not stimulate nipple- stop breastmilk production

recommendations with breastfeeding:

  • breastmilk should be part of diet until 2 years old

  • exclusive breastfeeding for first 6 months

what breastmilk contains:

  • hormones

  • enzymes

  • white cells

  • antibodies

  • transfer factor

  • bindus factor

  • anti-inflammiroty molecules

colostrum:

  • first breastmilk produced

  • production starts in 16 weeks pregnant

  • continues to be produced 3-4 days postpartum

  • is thick/ yellow and produced in small quantities

  • first feed is usually 5ml as babys kidneys are small and colostrum is only milk being produced

  • easy for newborn to digest

  • helps baby empty bowels

  • large amounts of nutrience- concentrated

  • contains antibodies and white blood cells to help w immune system

  • contains anti-inflammatory properties and probiotics for baby gut and fight pathogens

  • contains hormones- insulin/ thyroid-stimulating hormone (TSH)/ growth factors

mature breastmilk:

  • produced around 3-4 days

  • large qualtities produced in

nurtience in milk:

fats:

  • main source of enerdy

  • long-chain fatty acids- support eye and brain development

  • triglycerides easily digestable

protien:

  • 40% casein/ 60% whey protien

  • casein help transport calcium and phospherate from milk

  • whey forms curdles in stomach- easy to digest

  • promote good bacteria growth in stomach

prebiotics:

  • promote good bacteria growth in stomach

  • reduce PH of gut- harmful to bacteria+ cant grow

carbs:

  • lactose- main carb and easily broken into glucose

  • lactose aids brain development and growth of good gut bacteria

vitamins:

  • vitamin A

  • Vitamin E

  • vitamin D supplimentation needed for breastfeeding mothers

iron:

  • levels lower than formula milk but more bio-available in breastmilk than formula

immunoglobulins_

  • maternal antibodies contained in milk

  • new antibodies produces and transfered though milk- response to pathogens

breastmilk VS formula milk