Anatomy & Physiology: Milk production

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Anatomy & Physiology Topics
Table of Contents
Pre module evaluation
Structure of the Human Breast
Physiology of Breastfeeding
Milk Composition
Mature Milk Components
Supplements
Post module evaluation
References

Milk production is initiated in the breasts in the post-partum period due to prolactin production and decreased estrogen and progesterone after delivery of the placenta. The onset of lactogenesis (the production of breast milk) has been shown to be delayed by stressful events around delivery. Women who underwent an urgent Cesarean section or had a long duration of labor before vaginal deliveries were more likely to have a delayed onset of breast fullness in the first days after delivery ( Memorize Dewey, 2001 ). By day 3 or 4 post-partum, stimulation of the breast by suckling is required to continue milk production. Mothers produce milk between feedings due to elevated baseline levels of prolactin. They produce more milk during feedings due to the prolactin surge caused by suckling ( Memorize Lawrence, 2005 p79-86, Memorize Daly (part 2), 1995 ).

During continued lactation, milk production is based on infant demand. The average mother's ability to produce milk is much greater than the average infant's appetite ( Memorize Daly, 1995 ). The rate of milk production varies over the day. If a breast is not emptied at the end of the feeding, that breast produces less milk prior to the next feeding than it would have if the breast had been emptied completely ( Memorize Daly (part 2), 1995 , Memorize Wilde, 1998 , Memorize Peaker, 1998 ). Suckling or any nipple or breast manipulation stimulates sensory nerves in the areola and nipple. These nerves stimulate the pituitary gland to release oxytocin along with prolactin. A conditioned milk ejection can occur when a woman hears her baby cry. This is due to a conditioned release of oxytocin without the release of prolactin ( Memorize Lawrence, 2005 p79-86).



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