importance and advantages of breast feeding

1. Breastfeeding
MID370S
19 February 2024
Sellers: Chapter 9

2. Objectives
• Demonstrate knowledge of the anatomy and
physiology of human lactation
• Demonstrate the ability to apply your acquired
knowledge in educating women in the antenatal
and postnatal periods with regards to the
production of breastmilk
• Demonstrate the ability to provide support on
breastfeeding techniques
• Demonstrate knowledge of the strategies for
protection and promotion of breastfeeding
• Identify advantages of and contraindications to
breastfeeding

3. Introduction
• To date there is no true substitute for breastfeeding
• Replacement feeding has been adapted to suit various
special needs of infants
• Breastfeeding is the mother's choice, and she needs to
be supported in whatever choices she makes
• In places where breastfeeding is universal or the
norm,this needs to be protected
• As midwives we have thorough knowledge of the
anatomy and physiology of the breast and other
factors that might affect a womans feeding choice

4. Anatomy of the
female
breast(self
study)

5. Terminology
• Lactogenesis: Onset of milk secretions through a
series of mammary epithelial cellular changes
whereby alveolar cells are converted from a non-
secretory state to a secretory state
• Galactopoiesis:Requires prolactin for milk secretion
and oxytocin that is critical for the breastmilk let-
down reflex in response to suckling
• Hypergalactia: Refers to over production of
breastmilk
• Galactorrhoea: Abnormal milk production
• Agalactia: Indicates an inability to lactate

6. The
physiology of
lactation:
Hormonal
influences on
the breast
• Oestrogen and progesterone are
responsible for breast development
during pregnancy and lactation
• During pregnancy prolactin and
oestrogen increases the development
of the duct system of the breasts
• Prolactin is responsible for secretion of
milk
• Secretory effect of prolactin is inhibited
by high levels of oestrogen and
progesterone during pregnancy

7. Hormonal
influences on
the breast
• With the delivery of the
placenta oestrogen
and progesterone drops
• Prolactin increases –
promoting milk
production
• Initiating lactation

8. Hormonal
influences on
the breast
• PROLACTIN:
• Anterior pituitary gland
• Let down reflex (secretion of
milk)
• OXCYTOCIN:
• secreted when baby suckle
• By the Posterior pituitary gland
• Involution (contraction of uterus)

9. Hormonal
influences on the
breast
• Oxytocin is stimulated
when the baby is suckling
–hearing/seeing baby
• It causes the
myoepithelial cells to
• contract and allows the
milk to be expressed -LET
DOWN REFLEX

10. Lactogenesis (Initiation and production of
breastmilk)
• Stages of milk production are colostrum, transitional milk and mature milk
• Colostrum is present during pregnancy and the 1st food for the infant
• Thick yellowish fluid rich in Vit A and continues to secrete 2 weeks postpartum abd has
the following benefits
• Provides a continuation of the immunity that was available to the fetus via placenta
• Rich in immunoglobins which protect the infant from viruses and infections
• It is high in protein, fat soluble vitamins and minerals
• High amounts of sodium,potassium,chloride and cholestorol to encourage development
of the baby's heart, brain and CNS

11. Lactogenesis
(cont.)
• Volume varies between mothers and is about 2-
10ml per feed per day for 1st three days
• Transitional milk produced between day 7-10 for
two weeks
• Gradually changes to mature milk
• Mature milk will be present after 14-21 days and
looks watery rather than creamy because of the
high concentration of whey
• Breastmilk meets the requirements of the baby,
and no added water is need
• When hormones are released, lactation starts
• Maintained by stimulation of the nipple and
emptying of the breast

12. Lactogenesis
(cont.)
• Milk production depends on suckling that
releases the hormones for milk production
• Rate of milk synthesis is 11-58
ml/hour/breast
• Regular emptying of the breasts is main
way to produce more milk
• The composition of milk is influenced by
the mother's fluid and food intake

13. Synthesis of
human milk
• Increased blood flow to the
breasts,GIT,liver and increased cardiac
output
• Increase in metabolic rate –place burden
on thyroid gland and the
• Thyroid gland is enlarged during lactation
• Milk is synthesised in the alveolar cells
• The epithelial cells of the milk gland
contain stem cells
• And are highly specialised at the terminal
duct

14. Synthesis of
human milk
(cont.)
• Breastmilk changes through the course of a feed
and throughout the day
• Secreted as foremilk 1st and satisfies the baby's
thirst
• Hindmilk is produced as the feeding progresses
and is high in fat and calories to promote growth
and development of the baby
• Preterm milk differs from full term milk offering
preterm babies longer access to colostrum
• It contains higher levels of immunoglobin A (IgA)
triglycerides and long chain fatty acids
• Protects against necrotizing enterocolitis
(NEC)which is a fatal condition in premature babies

15. Properties
of human
milk
• Immunological properties: Decreases the infant's
chances of developing allergies, respiratory
infections, otitis media and asthma
• Enzymes: Enters mothers' milk from the maternal
intercellular fluid and others are broken down in
the mammary cells. Assists with fat metabolism
• Electrolytes, minerals and water: Human milk as
lower monovalent ions and higher lactose content
than the mother's plasma (distinguishes human
milk from that of other species)
• Glucose metabolism: Key function in milk
production and main source of energy
• Fats: Alveolar cells are able to synthesise short-
chain fatty acids

16. Properties of human
milk (cont.)
• Protein (nitrogen): Produced by free amino acids in the
cells. Protein is 75% of total nitrogen in human milk vs 95%
in cows' milk. Human milk is low in curd, due to high whey
content and is easily digested. If breastmilk is left standing
the clear fluid seen is whey
• Vitamin content: Dependent on the nutrition and vitamin
intake of the mother and can be critically low if mother is
malnourished
• Nucleotides: Important in protein synthesis and provide
energy for biosenthesis.Play a role in anabolism and
growth. Failure to thrive on breastmilk may be because of
low nucleotides in the breastmilk

17. Advantages of breastmilk
• Breastfed babies have a decrease chance of developing:
• Respiratory and ear infections
• Allergies and atopic diseases
• Asthma
• UTI
• Diarrhoeal infections, gastrointestinal reflux and NEC
• Bacterial meningitis
• Sudden infant death syndrome (SIDS)
• Childhood lymphomas Hodgkins's disease and leukaemia

18. Discontinuation/avoidance of
breastmilk
• Agalactia (inability to breastfeed):Breast surgery,
retained placenta,Sheehans syndrome where a women
fails to lactate
• Suppression of breastmilk: Suppressed by hormonal
contraception,HIV,drugs or prescription medication that
may affect the baby
• Replacement feeding and milk banks:Should a mother
be unable to breastfeed replacement feeding may be an
option. Infants can get the benefits of breastmilk
through a certified donor milk banks (DMB)
• Social factors: Differs between cultures and
socioeconomic groups
• Psychological factors: May include a woman's own
relationship with her mother, relationship with partner,
whether pregnancy was planned or unplanned

19. Contamination of
breastmilk
• Reflects contamination found in the
environment
• Monitored throughout the world to
determine the level of toxins in the
environment