Breast milk is nature's best food for feeding your baby because it contains the right amount of nutrients to keep your newborn healthy and happy. The production of breast milk may seem mysterious, but it is a natural process that starts before you are pregnant.
If you have had breast reduction surgery, small breasts have a benefit over large breasts. Breast reduction surgery can reduce chronic back, neck, and shoulder pain, and chronic rash or skin irritation under the breasts. However, there may be consequences, such as limited ability to nurse after the surgery.
Discussing this issue with your healthcare provider is critical to understanding your options. Breast reduction can damage the nerves as well as the milk-producing ducts and glands. The extent of your nursing ability after breast-reduction surgery depends on the extent and type of surgical procedure.
If the nipple and areola (the circle on which the nipple rests) are still attached to the breast tissue, you may be able to nurse. However, if you have had breast reduction surgery where the nipple and areola have been removed and reattached, these will not have access to the nerve endings and milk ducts necessary for milk letdown.
When a baby starts to nurse, milk letdown is triggered through nerve stimulation in the nipple and areola. Nerve stimulation is essential to trigger the release of prolactin and oxytocin. These are the natural chemicals that signal milk flow when a latched-on baby is trying to feed.
Nipple piercings are a type of breast surgery and should be avoided if you want to nurse your children. Piercings can scar and block the milk ducts leading to mastitis, a bacterial infection.
Other breast structure problems include women not having enough milk-ducts to produce milk. Ducts can grow during each pregnancy. Breastfeeding stimulates the growth of more ducts. Hormones and other factors can also affect milk production. Women with polycystic ovary syndrome (PCOS), diabetes, high blood pressure (hypertension), a low or high thyroid count, or hormonal problems can have low milk production. The production relies on hormonal signals sent to the breasts.
Hormonal birth control can interfere with milk production. Having your health problems treated or using alternative birth control methods, such as barrier methods, can help you make more milk for your baby. Talk to your healthcare provider about your medical conditions or and non-hormonal birth control methods that are available during nursing.
Breasts are milk-producing glands composed mostly of fat and ligaments that rest on top of the chest (pectoral) muscles. Under this layer of fat is a network of ducts that express milk out of your body.
The milk-producing part of the breast is organized into 15 to 20 sections, called lobes. These lobes divide into lobules that house tiny sacs called alveoli that produce breast milk. Tiny ducts carry milk into larger ducts and transport the milk from the lobules out to the nipples. These structures are already in place by the time you are born. However, the glands aren't active until puberty when estrogen causes them to grow into breasts.
Breasts after puberty come in various shapes and these shapes are inherited, genetic traits. Don't worry if your breasts aren't large. As with many good things, size does not matter. This is true about breasts and milk production. Small breasts can produce the same amount as big ones.
During pregnancy and the first days after you give birth, milk relies on hormones from your endocrine system to be available. Breast milk creation starts halfway through pregnancy with colostrum. High levels of progesterone during pregnancy inhibit milk secretion.
After delivery of the placenta, progesterone, estrogen, and HPL (human placental lactogen, a hormone found in the placenta,) breaks down fats from the mother to provide energy for the baby.) High prolactin (pro-milk hormones) levels take over and allow milk production. This hormonal change happens 30 to 40 hours after birth, but increased breast fullness does not occur until two to three days after the birth.
Breastfeeding enters a third stage, the autocrine (local) control system where milk removal and replenishment is controlled by the baby's appetite. Hormones at this stage do not have as great a role. Essentially, the baby's feeding will stimulate the mother's body to make more milk.
Milk contains a small whey protein called feedback inhibitor of lactation (FIL) that slows milk creation when the breast is full. When milk accumulates, FIL prevents more milk synthesis. An empty breast means less FIL that signals the body to fill your breasts again.
There are two important types of breast milk, colostrum and mature milk. Colostrum is the first milk you will experience as a nursing mother. It is pale, yellow milk prepared by your body before you give birth. Often it will show on your nipples in the last weeks of pregnancy.
This milk is high in antibodies, such as white blood cells. It offers the infant's first protection against disease. It is also higher in protein, minerals, vitamin A, nitrogen, but is less fatty and more sugary than mature milk.
Colostrum also has a laxative effect to help newborns get rid of meconium, the waste product accumulated before birth. Getting rid of meconium helps prevent jaundice in your newborn. Mature milk develops after the newborn nurses for a few days. This milk is fattier with more sugar than colostrum.
The fat in mature breast milk has a purpose much like butter sticks polar explorers eat during their cold journeys, to maintain body weight. Breast milk fat builds and maintains body weight and muscle in infants. Babies need calories when they are growing and the thin milk of colostrum, while it is good for giving a boost to a newborn's immune system, doesn't supply enough energy to build a baby's body.
There are two stages of breast milk: foremilk, and hindmilk. Foremilk is the first milk from your breast during a feeding session. This stage of milk is mainly water and is usually a bluish-gray color. It contains essential proteins and other nutrients but lacks more fats.
Hindmilk is the second stage of milk, which contains more lipids (fats) and calories necessary for building not only your baby's body but his or her brain. Without the creamy white hindmilk, the baby's brain would be starved of fatty acids that build healthy brain cells. It's important to nurse to an empty breast to assure your baby has the benefits of both stages of breast milk.
Through nursing and pumping, keeping your breasts empty throughout the day is important to maintain a steady milk supply. Nurse more often and/or add pumping sessions between the times you nurse, and empty the breasts as much as possible when you nurse or pump.
Make sure your baby nurses efficiently with proper latching on. Babies should latch onto the nipple and the surrounding areola. The nipple contains the holes that provide the milk, but the areola supplies the ducts providing the milk. The milk won't go through the nipples without the baby's mouth pressing down on these ducts and pressing the milk into the nipples.
To properly latch on, hold your breast with your free hand and place your thumb above your nipple where your baby's nose will touch your breast. Your index finger should be where your baby's chin will rest on the breast. Now, gently compress your breast so it has a shape like your baby's mouth. After bringing your baby to your breast, stroke his or her cheek to stimulate what is called the rooting reflex, and turn your baby's head to your breast.
Tickle the baby's lips until the baby's mouth open wide. Bring the baby to your breast and allow the baby to latch on. The baby's chin and the tip of the nose should touch your breast, and your baby should start feeding.
Let the baby feed until the breast is empty. Repeat the process with the other breast until it is empty. If you have difficulty getting your baby to latch on, consult a lactation specialist.
Sometimes, a baby will not fully empty the breasts. Pump your milk if the baby does not fully empty and soften both breasts or if you are in a situation where you cannot regularly nurse.
Pumping can be done between nursing sessions when your breasts are full. The volume of milk, however, is different throughout the day. Milk volume in the morning is more plentiful, and the volume gradually decreases throughout the day.
The stages of the milk expression are also different. Milk in the morning has less fat content, as foremilk than milk at the end of the day. This makes sense as the fattier milk, the hindmilk, is a later feeding before the baby goes to sleep and misses daytime feedings while asleep.
Sleep is also the time when your baby is growing. The extra fats and calories of evening hindmilk aid in the growing process during sleep. If you are concerned about the quality of your milk when you are pumping, a lactation specialist can measure the content of your pumped milk with a machine called a creamacrit, and give you advice about the fat and calorie content of your milk.
Whether you nurse or pump, breastfeeding is a healthy choice for your baby. You can be a successful nursing mother by understanding how the nursing process works.
Improper latching-on and not emptying the breasts will not only deprive your baby of essential nutrients, but can lead to having sore, cracked nipples that can develop into inflammation and mastitis, a bacterial infection requiring antibiotics. Preventing cracked nipples is also a matter of hygiene. Wash your nipples with only warm water and air dry. Avoid using soap when you are washing your nipples because soap can dry the nipple tissue and cause it to crack.
Don't ignore inflamed, sensitive breasts or treat them on your own without professional healthcare. Sore breasts are signs of an infection and can lead, if untreated, to the breasts developing abscesses that possibly could require hospitalization and surgery. Consult with your healthcare provider if you develop sore breasts or nipples.
If you do develop mastitis, continue to nurse. Not nursing during treatment for mastitis will continue to inflame and injure your breasts. If nursing hurts too much during your treatment, pump your breasts and use the pumped milk. It won't hurt your baby if you nurse during treatment for mastitis.