Stanya ( स्तन्य ) & physiology of lactation.pptx

PRESENTED BY – DR. AMRIT KOUR
KRIYA SHARIR DEPARTMENT
R.G.G.P.G Ayurvedic College & Hospital
Paprola

दोषधातुमलमूलं हि शरीरम्' (सु.सू. १५/३)
 "दोषधातुमल मूलं सदा देिस्य (अ.ि.सू. ११/१)
Roots of tree are very important
for maintenance, stablity and growth of a tree,
 similarly Dosha, Dhatu and Mala are very
important for maintaining human body. All these
together keeps the body in balance.

Updhatu
Meaning of Up is Sub, sub ordinate ,subsidiary,
secondary and
& Dhatu means tissue.
supplementary support
 Definition
Elements of the body which are derived from Dhatus and
which are not further subjected to any transformation are
called Upadhatus.(Charakpani)

Substances that are present in the body which
only perform Dharana Karma & do not provide
nourishment like Dhatu is Updhatu.
The main difference between Dhatu and
Updhatu is that any changes or vitiation in Dhatu
results in the effect in Uttar Dhatu but this can’t
happen in case of Updhatu

Food after digestion takes two forms viz. the Prasada
part (Annarasa) and the Kitta part (Mala)
From Prasadaja portion all the Dhatus are formed in
progressive order.

Updhatus According to Acharay Charak
 रसात् स्तन्यं ततो रक्तमसृजः कण्डराः हसराः ।
मांसाद्वसा त्वचः षट् च मेदसः स्नायुसंभवः ।।
(च.हच. १५/१७)
1.Stanya (breast milk)
2. Raja (menstrual fluid)
3.Kandaras (tendons)
4.Sira (blood vessels & nerves)
5.Vasa (muscle fat)
6. Twak (skin)
7. Snayu (nervous tissues & ligaments) DALHANA = SnayuSandi

Stanya as Updhatu
Stanya is the updhatu (secondary tissue) of
Rasa.
स्तने जायहत इहत स्तन्यं । हनरुक्तक्त
breast milk is secreted in mammary gland
therefore is called 'Stanya‘
रसात् स्तन्यं । च.हच.१५
स्तन्यं क्षीरं रसस्य उपधातुः।शा.१.१५ आढमल
Updhatu of Rasadhatu is breast milk.

स्तन्यं जीवनहमहत बालजीवनम् । (सु.सू. १५/९ पर
चक्रपाहि)
For the nourishment of baby, the milk
which is secreted in the mammary
glands is called stanya.

Properties of Breast Milk
यत् क्षीरमुदक
े हक्षप्तमेकीभवहत पाण्डुरम् ।
मधुरं चाहवविण च प्रसन्नं
तहद्वहनहदणशेत् ।।su.ni.10/26
Acharya Sushruta describes the qualities of Suddha
Stanya as-
Which mixes well with water immediately. White in
colour.
Sweet in taste and free from any discoloration . Is

 स्तन्यमप्स परीक्षेत, तच्चेच्छीतलममलं तनु

 शङ् खावभासमप्सु न्यस्तमेकीभावं गच्छत्यफ
े हनलमतन्तुम,
तेन क
ु मारस्यारोग्यं शरीरोपचयो बलवृक्तिश्चभवहत ।। ३५।।
 Acharaya Sushruta aslo described qualities of suddha stanya in Sharir
sthana 10 as-
 Examination of breast milk should be done in water.
 Suddha stanya should be cold, clean, thin.
 whitish yellow in colour like the colour of conch.
 It should be free from foam and fibers
 should disperse uniformaly in water,neither floats nor sinks.
 This kind of stanya provides a child with health & strength.

 स्तन्यसंपत् तु प्रक
ृ तविणगंधरसस्पशणम् उदपात्रे अवदुह्यमानम् इयक व्येहत
प्रक
ृ हतभूतत्वात् तत् पुहिकरम् आरोज्यकर चेहत स्तन्यसंपत्। च.शा. ८.५५
Good quality breast milk is with physiological appearance of color, odor,
taste, and touch and if dropped into water: assimilates in water due to
its normal density.
Such breast milk is nourishing to a baby and is called good quality
breast milk.
Good quality is realized by:
Color: clear milk with milky white color
Odor: typical milky odor.
Taste: sweet.

गृिीतगभाणिामार्त्णवविानां स्रोतसां वमाणन्यवरुद्ध्यन्ते
गभेि, तस्माद् गृिीतगभाणिामार्त्णवं न दृश्यते,
ततस्तदधः प्रहतितमूर्ध्णमागतम अपरं
चोपचीयमानमपरेत्यहभधीयते।
 शेषं चोर्ध्णतरमागतं पयोधरावहभप्रहतपद्यते, ततस्तदद्यः
प्रहति तस्मादगहभणण्यः
पीनोन्नतपयोधरा भवक्तन्त ।।( Su.Sha.4/२४)

Sushruta Acharya- After Conception, orifices of
artavavaha (reproductive) srotas of pregnant woman
gets obstructed by the foetus and menstrual cycle is
ceased hence artava cannot come out of vagina.
 Obstructed artava takes part in formation of
placenta while
 remaining part travels in upward direction, reaches
the breasts, helps development of lactiferous ducts
of breasts and prepares them for the production of
stanya.

धमनीनां हृहदस्थानां हववृतत्वादनन्तरम् ।
चतुरात्राक्तरिरात्राद्वा स्त्रीिां स्तन्यं प्रवतणत ।
(
Su.Sha.10/16)
 Post partum, the excess of vata constricts the artavavaha srotas
and dilates the lactiferous ducts of mammary glands and thus
the actual secretion of milk takes place on third or fourth day.

Formation of Stanya (breast milk)
रस प्रसादो मधुरः पक्वािारहनहमर्त्जः ।
क
ृ त्स्न देिात् स्तनौ प्राप्तः स्तन्यहमत्यहभधीयते ।।
 (सु.हन.
१०/१८)
Excel part of Rasadhatu ,sweet ,generated
from digested food after circulating in entire
body when reaches two breasts,it is called

Ejection of breast milk
आिाररसयोहनत्वादेवं स्तन्यमहप क्तस्त्रयाः ।
तदेवापत्यसंस्पशाणद्दशणनात् स्मरिादहप ।।
ग्रििाच्च शरीरस्य शुक्रवत् सम्प्रवर्त्णते ।
स्नेिो हनरन्तरस्तत्र प्रत्रवे िेतुरुच्यते ।।
(सु.हन.
१०/२२,२३)

When the mother feels baby's touch, or the
mother sees her baby or picks the baby up;
even its memory stimulates breast milk As
Ahararasa circulates in entire body, these
nutrients circulate in entire body before
reaching its destination, breasts. Ceaseless
love for the baby is supposed to be one of
important factor for
production of breast milk.

Time of breastfeeding according to
different Acharyas -
According to Acharay Charak – Dugdhapaan
(breastfeeding) should be done on the 1st day of
postpartum period but before that Lehana with madhu
& sarpani should be done.
According to Acharay Sushruta & Vagabhaat-
Dugdhapaan should be done on the 4th day of
postpartum period.

Benefits of Stanya-
जीवनं वृंििं सात्म्यं स्नेिनं मानुषं पयः ।
नावनं रक्तहपर्त्े च तपणिं चाहक्षशूहलनाम् ।।
(च.सू. २७/२२४)

As per Charak Acharya, Human milk is
responsible for Jeevanam, Bhrahanam,
Satmyam and Snehanam.
 It is responsible for proper nourishment
,growth and proper strengthening of
body constituents in infants.
In Raktapitta, it is used for Nasya.
It is used as Tarpana in Netra shoola.

प्रक
ृ हतभूतत्वात्, तत् पुहिकरमारोग्यकरं
चेहत ।
(च.शा. ८/५४)
Acharya charak has described
milk as nourishing and healing
by nature.

मातुरेव हपबेत्स्तन्यं तत्परं देिवृिये ।
(अ.हृ.उ. १/१५)
Breast milk is responsible for
deha- vriddhi(body growth) of
infants.

नायाणस्तु मधुरं स्तन्यं कषायानुरसं हिमम् ।
नस्याश्योतनयोः पथ्यं जीवनं लघु दीपनम् ।।
(सु.सू. ४५/५७)
According to Acharaya Sushruta, milk
of a woman is sweet in rasa. Anurasa
is kasaya, beneficial for nasaya &
aschyotan , pathya(satamya), jivniye,

मानुषं वातहपर्त्ासृगहभघाताहक्षरोगहजत् ।
तपणिाऽऽश्चोतनैनणस्यैः.
(अ.सं.सू.- ६/५९, अ.हृ.सू. ५/२६ )
According to acharya vagbhata,
Woman’s milk is beneficial for Tarpana,
Aschyotan & Nasya in akshiroga(eye
disease), diseases due to Vata,Pitta,
Rakhta and Abhigata(Trauma).

Physiological measure -
द्वांजली तु स्तन्यस्य। अ.हृ.शा. ३.८२
Measure of normal secretion of breast
milk is two anjali.

Stanya Kshaya – causes
क्रोधशोकावात्सल्याहदहभश्च क्तस्त्रयाः
स्तन्यनाशो भवहत । shu.sha.10/34
 Causes – Anger, grief, lack of love for the child etc.

Stanya Kshaya – Lakshana
स्तन्यक्षये स्तनयोम्र्लानता स्तन्यासम्भवोऽल्पता वा ।
तत्र श्लेष्मवधणन द्रव्योपयोगः ।(सु.सू.१५/१६)
 Symptoms – looseness or wrinkles in the breasts, absence or less amount of
milk in the breasts .
 Treatment – kapha enchanching substances.

Stanya vriddhi lakshana -
✓स्तन्यं स्तनयोरापीनत्वं मुहुमुणहुः प्रवृहर्त्ं
तोदं च । (सु.सू. १५/२१)
Symptoms – heaviness of breasts
Engorgement in the breasts
Needle pricking pain

Disorders and effects of unfit
breast milk-
Breast milk when gets vitiated by Dosha is not
fit to feed the baby.
Tests are given to diagnose such milk.

Charak expained 8 types of abnormalities in breast
milk (ksheer Dosha) based on the dosha promience
.

Types of Stanya dusti with their clinical features -
 VATAJA STANYA DUSHTI -
 1. VAIRASYA –
 karshya (emaciation) in child,
Swadate na-stanya – (breast milk does not taste
good)
Kruchhrena vardhate – delayed growth of the child.

2. PHEN-SANGHATA –
Kricchra pravartana ( difficulty in expression of breast milk)
Kshamaswarata (dull voice)
Purisha – mutra graha ( retention of feces & urine)
Causes vataj shiroroga ( headache)
Peenasa ( sinusitis)
3. RAUKSHYA –
Balahrasa ( weakness)

Pittaj Stanya Dushti -
 4. VAIVARNYA –
Discolouration of Stanya ,
Gatravaivarnaya – discolouration of body parts.
Swedana – Adhikya ( excessive perspiration)
Trishna – Adhikya(excessive thirst)
5. DURGANDHYA –
Occurance of Pandu & Kamala in the child .

KAPHAJA STANYA DUSHTI
 6. Ati - SNIGDHA –
Chardana (vomiting)
Kunthana ( discomfort or pain )
Lalastrava ( excessive salivation )
 Strotas Rodha ( obstruction of body channels )
Nidra ( sleepiness )
Klma ( lethargy)

 7. PAICHILLYA –
 Lalastrava ( Salivation)
 kshunakshi vaktrayada - ( inflammation in the buccal
cavity , eyes )
 8 . GAURAVA – Hridroga (heart disorders )

Stanya vitiated By Dosha------
VAGBHATA
When vitiated Vata affects milk, it floats on water,
When vitiated Pitta affects milk, it creates yellow
streaks in water.
When vitiated Kapha affects milk, it sinks in water.

Diseases in neonates due to abnormal
breast milk
 Ashtang Sangraha explains the variety of diseases like jwara (fever), kasa
(cough), chhardi (nausea, vomiting, gastric disturbance) commonly observed in
the paediatric population.
 Ksheeralasaka and Parigarbhika are two most common diseases
observed in neonates.
 Ksheeralasaka is a condition involving the vitiation of all the three dosha
resulting in symptoms like diarrhoea, malaise, fever, vomiting, nausea etc.
the child.
 chronic indigestion and disturbed gastro-intestinal functioning,
which is commonly observed in breast fed infants.

Parigarbhika = malnutrition related disorders.
 It has been explained as an important factor resulting from the
abnormal breast milk.
 Similarly, other conditions like kukunaka (opthalmia neonatarum)
and ahiputana (napkin rash), [Su. Sa. Chikitsa Sthana 20/57]
charmadala (skin disorders) (K. S. Khila Sthana 15/10),
 utfullika (H. S .3.54.9-13),
visarpa (herpetic rash) (K.S Khila Sthana 14/10-15)
 also result from vitiated stanya leading to the occurrence of range
of disorders in the paediatric population.

Aversion of the infant towards breast feeding (stanya
dwesha) is considered a sign of graha dushti
e.g. skanda, skandapasmara, andhaputana. [Su. Sa.
Shareera Sthana 10/51, A.H. Uttar Tantra 3/5].
 It is also observed in conditions like mukha roga,
kantha roga , trishna ,udarashool .

Substitute breast feeding -
1. Chhaga paya (goats milk)
 2. Gavya paya (cow milk)
3. Laghu- panchamula siddha ksheera
with sitopala

Structure of Breast -
 Breasts have mammary glands which are modified sweat
glands involved in lactation or production of milk.
 Breast arises from the surface epithelium as solid
column of cells which gradually is hollowed out to
become ducts.
 These ducts branch to give rise to terminal
ductules which is turn lead to alveoli.
 Myoepithelium – Elongated branching
striated cells .
 cover the external surface of epithelium of the
alveoli and ducts .

It consists of-
1. Skin – nipple, areola.
2. Parenchyma / Glandular tissue /
mammary gland.- secrete milk to
feed newborn baby.
3. Stroma – cooper’s ligament.
cover the breast.

oNipple- central protruding part of breast.
oConsists of Smooth muscle fivers.
oAreola – pigmented skin area that
surround the nipple .
oIt consists of numerous
sebaceous sweat glands – which
enlarge during pregnancy and
secrete oily substance to
lubricate the nipple.– Montgomery’s glands.

 Breasts have mammary glands/glandular tissues/ Parenchyma.
 Each Breast consists of about 15- 20 lobes which are further divided
into lobules(produce milk).
 Lobules consists of tiny hollow sacs called
Alveoli.
 Drain into single lactiferous duct and
converge at nipple.
 Before that dilate at lactiferous sinus
(Ampulla).
This lactiferous sinus act as a reserviour of
Milk during lactation .

Mammary glands are surrounded and
supported by Connective tissue – Stroma .
It has fibrous & fatty components.
The Fibrous stroma forms – cooper’s
Ligament known as suspensory ligaments of
cooper.

Pectoral Fascia – Sheet of connective tissue
associated with pectoralis Major.
Retromammary space- layer of loose
connective tissue between the breast’s base
& the pectoral fasica

At birth-
The breast is rudimentary and
consists of a tiny nipple from which radiates a
few ducts.
 Further development occurs until the time of
puberty.

At Puberty-
 The beginning of changes in the mammary
gland is occurs at the time of pubery before
menarche.
 This development is stimulated by the
estrogens of the monthly female sexual cycle;

During Pregnancy -
 During 1st half of the pregnancy, ductal system develops
further with the appearance of many new alveoli.
 But there is no milk secretion .
 During the 2nd half of the pregnancy – growth of glandular
tissues occur
 colostrum is secreted during 2nd half of pregnancy but in a
very small amount.

Hormones involved in the growth of mammary glands
 1. ESTROGEN – responsible for growth & branching of ductal system of
mammary gland.
 Also responsible for fat accumulation in the breasts.
FOUR OTHER HORMONES –
1. Growth hormone
2. Prolactin
3. Adrenal glucocorticoids
4. Insulin
MODE OF ACTION ------- Help in PROTEIN METABOLISM

2. PROGESTERONE –
Promotes development of Lobule-
Alveolar System
Stimulates development of Glandular
tissues.

 3. PROLACTIN –
 Necessary for milk secretion .
 Normally , it is inhibited by PIH , secreted by Hypothalamus .
 During 5th month of pregnancy ,prolactin secretion starts
increasing .
 MODE OF ACTION – Act on mammary glands , causes
proliferation of Epithelial cells of Alveoli.

 4 . Placental Hormones –
 ESTROGEN & PROGESTERONE secreted from placenta
are essential for further development of mammary glands
during pregnancy .
 HUMAN CHORIONIC SOMATOMAMMOTROPIN –
it was first named human placental lactogen and
was believed to have functions similar to those of
prolactin.

5 . OTHER HORMONES –
GROWTH HORMONE
THYROXINE
CORTISOL
RELAXIN
Enhance growth & development of mammary glands
in the stages.

LACTATION –
Synthesis, secretion & Ejection of Milk is called Lactation .
It involves Two Processes –
1. Milk Secretion
2. Milk Ejection

1. MILK SECRETION
It is the synthesis of
milk by alveolar
epithelium and it’s
passage through the
duct system.
It occurs in TWO
PHASES –
• LACTOGENESIS –
Initiation of Milk Secretion .
• GALACTOPOIESIS --
Maintenance of Milk
Secretion

LACTOGENESIS -
 Small amount of milk secretion occurs during later months of
pregnancy .
 But free flow of milk occurs only after parturition .
 Milk secreted before & after parturition Called
 colostrum .
 Yellow in colour ,
 rich in proteins and salts ,
 sugar content is low
 No fat

ROLE OF HORMONES IN
LACTOGENESIS -
 PROLACTIN – responsible for lactogenesis .
 During 2nd half of pregnancy , large quantity of prolactin is secreted but
its activity is supressed by estrogens & progesterone secreted by plactenta
.
 So, lactation is prevented during pregnancy .
 Immediately after delivery of baby and expulsion of placenta, there is
sudden loss of estrogen & progesterone .
 Now, prolactin acts on breasts and promotes lactogenesis .

GALACTOPOIESIS -
 Maintenance of Milk Secretion depends upon following
Hormones –
 GROWTH HORMONES
 THYROXINE
 CORTISOL
 MODE OF ACTION – these hormones are essential for
continuous supply of glucose, amino acids , fatty acids
,calcium and other substances necessary for milk

ROLE OF HYPOTHALAMUS IN GALACTOPOIESIS -
The milk production is continued for 7 to 9 months after delivery only if feeding the
baby is continued. Suckling of nipple by the baby is responsible for continuous milk
production.
When the baby suckles, the impulses from
touch receptors around the nipple stimulate hypothalamus.
It is suggested that hypothalamus releases some
prolactin-releasing factors, which cause the
prolactin secretion from anterior pituitary.
Prolactin acts on glandular tissues and
maintains the functional activity of breast for
subsequent nursing.

B. MILK EJECTION -
 Milk ejection is the discharge of milk from mammary
gland.
 It is a neuroendocrine reflex.
 Milk ejection reflex or milk let-down reflex.
DEPENDS UPON – a. suckling exerted by the baby
 b. contractile mechanism in breast,
which expels milk from alveoli into the ducts.

Milk ejection reflex
 Plenty of touch receptors are present on the mammary glands,
particularly around the nipple.
 When the infant suckles mother nipple, the touch receptors are
stimulated.
 The impulses discharged from touch receptors are carried by the
somatic afferent nerve fibers to paraventricular and supraoptic
nuclei of hypothalamus.
 Now hypothalamus, in turn sends impulses to the posterior pituitary
through hypothalamo-hypophyseal tract.
 Afferent impulses cause release of oxytocin into the blood.

EFFECT OF LACTATION ON MENSTRUAL
CYCLE
 Woman who nurses her child regularly does not have menstrual
cycle for about 24 to 30 weeks after delivery.
 It is because, regular nursing the baby stimulates prolactin
secretion continuously.
 Prolactin inhibits GnRH secretion from hypothalamus resulting in
suppression of gonadotropin secretion from anterior pituitary.
 In the absence of gonadotropin,i.e there is no LH & FSH
production.
 the ovaries become inactive and ovulation does not occur.

 When the frequency of nursing the baby decreases
(after about 24 weeks) the secretion of GnRH and
gonadotropins starts slowly.
When sufficient quantity of gonadotropins is
secreted, the menstrual cycle starts.

Changes in mother during Lactation -
 At the height of lactation in the human mother, 1.5 liters of milk
may be formed each day & great quantities of energy is required ;
 Large amounts of metabolic substrates are also lost from the
mother. For example, about 50 grams of fat enter the milk each
day, as well as about 100 grams of lactose, which must be derived
by conversion from the mother’s glucose. Also, 2 to 3 grams of
calcium phosphate may be lost each day.

The output of calcium and phosphate by the
lactating mammae will often be much greater
than the intake of these substances.
 To supply the needed calcium and phosphate,
the parathyroid glands enlarge greatly, and
the bones become progressively decalcified.

Antibodies and Other Anti-infectious Agents in
Milk
Not only does milk provide the newborn baby with
needed nutrients, but it also provides important
protection against infection.
Particularly important are antibodies and
macrophages that destroy Escherichia coli bacteria,
which can cause lethal diarrhea in newborns.

Applied physiology of Mammary Glands

Breasts are usually affected by
three conditions –
Infection
Benign tumours
Malignant tumours

MASTITIS -
 Inflammation of breast tissues.
 Mostly occurs in breastfeeding women –
LACTATIONAL MASTITIS .
 Rarely seen in non –lactational women .
 CAUSE – occur due to blockage of
duct – leads to milk stasis .
 Signs and symptoms – PAIN
REDNESS & SWELLING .

BREAST ABSCESS -
 Buildup of pus .
 Cause – from infection – common in lactating mothers .
Staphylococcus Aureus .
 Bacteria may enter the breast via –
 Cuts on breast tissues
 cracked nipples
 SYMPTOMS – Pain, redness ,
 swelling , discharge.

Fibrocystic Breast Changes -
 Benign condition .
 Fluid filled cysts along with areas of fibrosis in one or both breasts .
 Associated with hormonal fluctuations . ( ESTROGEN Level rises)
 Occur between 30 to 50 years .
 Before menstruation = increases
 After Menstruation = Decreases .
 Signs & symptoms –
 not always .
 Pain , tenderness & lumpiness in the outer ,upper quadrant of breast .
 Sometimes discharge

Stanya ( स्तन्य ) & physiology of lactation.pptx

Stanya ( स्तन्य ) & physiology of lactation.pptx

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