2. Session 6 Objectives:
At the end of session, participants will
be able to:
1. Identify the parts of breast and describe their
functions
2. Discuss how breast milk is produced and how
production is regulated
3. Describe baby’s role in milk transfer
2
3. Introduction
In normal breastfeeding, 2 elements are
necessary for getting milk from breast to
baby :
1.A breast that produces and releases milk
2.A baby who is able to remove milk from breast
with effective suckling
•Breast Attachment is crucial
3
6. Inside the Breast
• Fat and supporting tissue - give breast its size
and shape
• Nerves - transmit messages from breast to
brain to trigger release of lactation hormones
• Alveoli - produce milk
• Milk ducts - carry milk to the nipple.
6ATTACHMENT
9. REASSURE MoTHER :
SIZE AND SHAPE
There are many different shapes and
sizes of breasts and nipples.
Amount of milk vs size ???
Babies can breastfeed from almost all of
them.
9
11. Milk Production
1st
stages of milk production are under control of
hormones
During pregnancy
Breast size
Colostrum
After delivery
Hormones of pregnancy drop
Large volume of milk 30-40 hours after delivery
Prolactin, Oxytocin 11
13. PROLACTIN
• Hormone that makes alveoli produce milk.
• Works after a baby has taken a feed - to make
milk for next feed.
• Can make mother feel sleepy and relaxed.
• Level is high in first 2 hours after birth
• Highest level at night
– breastfeeding at night allows for more prolactin
secretion.
13
15. • Causes muscle cells around
alveoli to contract & makes
milk flow down ducts.
– essential to enable baby to get
milk.
( Oxytocin reflex/ milk ejection
reflex/ letdown)
• It may happen several times
during a feed.
OXYTOCIN
15
17. Signs of Oxytocin Reflex
Painful uterine contractions, sometimes with a
rush of blood
Sudden thirst
Milk spraying / leaking from breasts
Squeezing sensation in breast
** may NOT always feel physical sensation
17
18. How mother can assist
Oxytocin to work
• Seeing, hearing, touching and thinking lovingly about
baby
• Confident
• Relax
• Expressing little milk and gently stimulating nipple
• Extreme pain X
• Stress X
18
20. How to prevent FIL from collecting and
reducing milk production ?
Make sure baby is well attached
Encourage frequent feeds
Allow baby to feed for as long as she wants at
each breast
Let baby finish one breast before offering the
other breast
If baby does not suckle, express milk
20
22. Baby’s Role
• Baby suckling controls:
– Prolactin production
– Oxytocin reflex
– Removal of FIL inhibitor within the breast
• For mother to produce milk for baby’s needs
– Baby must suckle often
– Must suckle in the right way –NOT ON NIPPLE!
22
28. Signs that a Baby is NOT Suckling
Effectively
• Makes rapid sucks
• Makes smacking or clicking sounds
• Cheeks drawn in
• Fusses or appears unsettled at breast
• Comes on and off the breast.
• Feeds very frequently
• Feeds for very long time - > 1 hour EVERY feed
(unless LBW)
• Is not contented at end of feed
28
29. Artificial Teats and Suckling Difficulties
• Artificial teats and pacifiers may cause difficulties for
BF baby
– difficulty suckling at breast because of different mouth
action
– baby may prefer artificial teat and find it difficult to
breastfeed
• Artificial teats may…
Reduce suckling
time
Reduce breast
stimulation
Reduce milk
production
Reduce milk
renewal
29
30. What are the main ways to ensure a
good milk supply?
30
31. How to ensure a good milk supply?
Help baby to breastfed soon after birth
Make sure baby is well attached at breast
No artificial dummies or teats
Breastfeed exclusively
Feed baby as frequently as he wants, for as long as he
wants at a feed.
Feed baby at night
31
32. 1. Size and shape of the breasts are not related to
ability to breastfeed.
2. Prolactin and Oxytocin are 2 important
hormones in breast feeding.
3. FIL reduce milk production if breast is full
Milk production only continues when milk is removed.
4. Early feeding and frequent feeds help to initiate
milk production.
Summary :SESSION 6
HOW MILK GETS FROM BREAST TO BABY
32
33. Session 6 Knowledge Check
Describe to a new mother how to tell if her
baby is well attached and suckling
effectively.
33