congenital gus disorder

5.  The endocrine control of lactation can be
divided into following stages:
1. mammogenesis
Preparation of breast (b) synthesis and secretion of
milk by breast alveoli
lactogenesis),
(c) ejection of milk (galactokinesis) and
(d) maintenance of lactation (galactopoiesis).

7. Why BF every 2-3 hrs
 When the alveolus is full of milk, the walls
expand/stretch and alter the shape of prolactin
receptors so that prolactin cannot enter via those
receptor sites – thus rate of milk synthesis decreases
 As milk empties from the alveolus, increasing
numbers of prolactin receptors return to their normal
shape and allow prolactin to pass through – thus rate
of milk synthesis increases
 The prolactin receptor theory suggests that frequent
milk removal in the early weeks will increase the
number of receptor sites
 More receptor sites means that more prolactin can
pass into the lactocytes and thus milk production
capability would be increased

8. Factors limiting milk production and ejection
 Stress
 Pain
 Poor lactation
 Under nutrition
 Noisy environment
 infrequent suckling or
 due to endogenous suppression of prolactin (ergot
preparation, pyridoxin, diuretics or retained placental
bits)
NB. Drugs to improve milk production :Metoclopramide,
Sulpiride (dopamine antagonist), and domperidone

9. Lactation suppression in case of not breastfeeding ,
contraindicated or dead neonate include:
 stop breastfeeding
 avoid pumping or milk expression
 wear breast support
 ice packs to prevent engorgement
 analgesics (aspirin) to relieve pain and
 tight compression bandage is applied for 2–3 days

10. Advantages
 It providing complete food, easily digestible and well
absorbed.
 Protect against infectious disease to baby
 It promote emotional bonding to mother and baby
 It having high antibodies
 Breast milk having high nutritious, vitamin and
minerals
 It prevents babies from diarrheal infection
 It providing natural contraceptive to mother and
decreses PPH
 Decreases need for hospitalization

11. Breast feeding
Adequacy of breast feeding
 Satiety reflex
 Weight gain (objective and reliable)
 Frequency of diaper change
 Milk ejection reflex
 Breast engorgement

12. Breast feeding
Techniques of breast feeding
Positioning
 Straight body, whole body supported, facing and
touching the mother
Attachment
 Open mouth, lips everted, more areola visible above
the upper lip than below
Frequency
 Every 2-3 hours or 8-10 feeds per 24 hours

13. Breast feeding
Contraindication of breast feeding
Maternal
 HIV, Breast cancer, breast abscess
 Postpartum psychosis, active TB,
 Drugs like psychotropic, chemotherapy, radioisotopes
 Substance abuse like cocaine, heroin, amphetamine
Neonatal
 Lactose intolerance, critical illness
 Galactosemia (failure to convert galactose to glucose)

14. Reading assigment
1. Does diet affect the volume and constitution
of breast milk?
2. Differentiate breast milk and from formula milk?
3. Three stages of milk production