Mechanism of Milk Production

Your breast is composed of 20 odd lobes, also called segments. Placed more or less at the periphery are the secreting alveoli, surrounded by the cells of my myoepithelium. The ducts from the alveoli converge to form a solitary duct of each segment, opening on the surface of the nipple. During pregnancy the breasts enlarge and the body prepares the ducts and alveoli for lactation. After delivery, a hormone, prolactin begins to act on the alveolar cells and induces milk production. Sucking the nipple by the infant cause withdrawal of the two hormones, estrogen and progesterone. Secretion of a higher amount of prolactin enhances production of fat, proteins and lactose by the glandular tissue. Thus the milk secretion is initiated by prolactin. Its maintenance is regulated by the growth hormone and thyroxine. The propulsion of milk into the ducts and then from the nipple into the baby’s mouth is again stimulated by sucking. Sucking is, thus, of vital importance for both the phases of lactation. If the breast is not fully emptied, increasing pressure in the ducts is likely to inhibit secretions. The higher the demand, the greater is the production and supply of milk. That is why some women keep secreting enough milk years after the birth of their last child.

Medicinal value of Breast Milk

Breast-feeding, it is claimed, helps in spacing children. The chances of conception in a lactating mother are far less. Mind you, I said it “helps”-just helps, not that it is a dependable foolproof way for contraception. Mothers who breast-feed their babies show relatively a very low incidence of breast cancer. This is exemplified by the fact that breast cancer hardly hits the Jews who have a very high rate of breast-feeding. In recent years, considerable evidence has accumulated to show that human milk offers some protection against arteriosclerosis, a degenerative disorder of blood vessels.If you are well and the baby is well there is absolutely no disadvantage and no contra-indication of breast-feeding. It is not only superior most type of infant feeding but also a “must” for the infant. There is a widely held belief that breast feeding spoils the figure of the mother. In reality is just the other way round. Proper breast-feeding, in fact, improves and shapes the young mother’s figure. It enables the uterus to return to the normal size and also drains away extra fat that accumulates during pregnancy. Think hundred times with a cool mind before opting against giving your own milk to the baby.

Studies on Breast Milk

A recent investigation has demonstrated that the anti-infective factors continue to be present in significant amounts in mother’s milk even at the end of the first year of the lactation. These qualities of breast milk are of major significance for the infant’s defense against infection, particularly in the Third World countries where risk of infection is very high. Decline in breast-feeding in Singapore during 1951-1960 led to a loss of 1.8 million US dollars. On the world scale it has been estimated that marked decline in breast-feeding could lead to literally billions of dollars going down the drain. Even if you do not care what happens to the rest of the world or the statistics, just wait. Does it cost anything to feed the baby on your own breasts? Imagine if you have to go in for all those bottles, teats and milk powders. Breast-feeding contributes a great lot to establish sound and healthy mother - child interactions. The breast-fed infant has the close, warm contact of the mother’s body that has been compared to the “warm encompassing amniotic fluid (the water in which the baby floats while in the womb) which he just left”. Nursing the baby would decidedly give you much satisfaction and a sense of fulfillment. The baby too gets reciprocal contentment and pleasure.

Advantages of Breast Milk

Breast milk is more or less sterile. It has been convincingly shown in several studies that the incidence of respiratory infections such as cold and gastrointestinal infections like diarrhea is much less in breast- fed babies. This disease is a leading cause of death and ill-health in late infancy. Mother’s milk contains antibodies against food proteins as also cow’s milk proteins. Such antibodies are useful in blocking absorption of toxic or allergic food materials to which the infant has no local intestinal immune response of his own. Many experts believe that breast milk, if adequate, should be sole source of nutrition during the first 6 to 8 weeks of life. Introduction of foreign proteins, including cow’s milk – remember it – very early in life only hastens and facilities the induction of allergy. Mother’s milk is safe and nearly free from contamination. All that reduces the chances of infection. In contains several anti-microbial factors (agents which resist the invasion) which play an important role in defense against infection in the baby. There is also evidence of presence of antibodies against certain bacteria and viruses, and that includes virus that causes poliomyelitis, the paralysing disease. In short there is no substitution to mother’s milk.

Importance of Breast feeding

Human milk has been hailed as “a unique gift of love and a natural resource” by Dr. Derrick B. Jelliffe, one of the greatest authorities in infant nutrition. Every baby, as far as possible, must be breast-fed at least for the first 3 months and preferably for the 6 months of life. As and when there is doubt if the infant will be able to receive enough of proteins from elsewhere, he should continue to be fed on the breast for as long as 2 years or so. Remember, mother’s milk is not a “poor babies’ food” but food of choice for the infant. Breast-feeding is considered the best. Its outstanding advantages are that human milk has a composition that is ideally suited to meet the requirements of an infant. No other milk comes anywhere close to it in this connection. Remember, it may be possible to bring up an infant on milks of other species, it is quite impossible to humanize cow’s milk or for that matter any other milk. Mother’s Milk is always fresh, pure and ready for instant use, requiring no preparation. Human milk is always at a temperature which is best suited to the infant. You do not have to boil it and then make sure that it gets to the right temperature.

More about Post-natal Exercise

When you resume doing housework-do not delay it much – keep your posture straight and your muscles of the abdomen contracted. A lazy posture will make your muscles of the abdomen still more flabby and increase the waistline rather than make it trim. While climbing stairs contract your abdominal muscles and then climb upstairs. Remember to walk two stairs at a time. While standing contract your abdominal muscles. Bend forward from the hips while you hold the back of a chair. Try to push the chair with the contracted muscles of the abdominal wall. Stand with contracted abdominal muscles against a wall. Try to flatten the middle of the back against the wall. Try a few lying-down exercises. To begin with, lie on back, hands behind the head. Now, slowly raise yourself to the sitting position. Lie flat on back, arms stretched overhead. As you sit up bringing forward the body, try to touch the toes with your hands. Repeat several times. Lie flat on back, feet crossed. Now make the muscles of the abdomen and seat tight by contraction. Kneeling exercise is also good. Kneel on all fours, keeping your head high. As you contract the abdominal muscles, tuck your head under the arched back. Keeping your abdominal muscles contracted, kneel, sit on the heels and roll the head down on the knees.

Tips on keeping Fit after Delivery

For some women who are greatly exhausted during delivery and are also nervous may develop emotional disturbances, irritability and apprehension after the birth of the baby. Depression and insomnia may worsen the mother’s condition. The so-called puerperal psychosis responds well to reassurance and to drugs like tranquillisers and sedatives. If the condition takes a serious turn, the obstetrician would, as a rule, consult his psychiatrist colleague. Your doctor will also prescribe for you some haematinic tablets (iron, folic acid, vitamin B12’ B-complex or multivitamin in variable combinations) and/or calcium pills to improve your general health. See that you do not skip the dose. To tone up and bring back your abdomen to shape buy yourself a nylon abdominal belt and use it constantly to safeguard against abdominal “paunch” and the waistline getting too big. If you are a very outgoing type and addicted to swimming, please avoid it at least for the first 6 weeks after delivery. Do not forget to continue the postnatal exercise that you learnt in the hospital. Make “exercise” a routine. Something which always puzzles the young mother: When is “coitus” permitted after childbirth? Take an expert‘s good counsel. They say: “Avoid it during the first 6 weeks or so, perhaps a little longer if you can”.

Does and Don’ts after returning home

Once you are back home, make use of the routine you learnt in the hospital and follow the doctor’s advice and instructions religiously. During the first week, take plenty of rest, a good deal of it in the bed. Have small strolls but do not exert too much. Climbing stairs is not permitted. If you do not get exhausted, you may render a helping hand to the mother-in-law or others in doing easy things. There is nothing wrong in doing light pleasant reading, listening to the radio or watching the television, the idiot-box as many would like to designate it. Also, do see the visitors but avoid longish chatting sessions. After a week, you may increase your activity and render more help in cooking and other household affairs. You may now begin to climb the stairs. Sleep enough. Have a good nap in the afternoon too. In the third week, you may go shopping to the nearly market. You may also go out for an evening walk. Expose yourself to fresh air in your lawn and to the sunshine. Take care of your nutrition. Else you will be harming your physique as well as the baby you are breast-feeding. Include in your diet milk, cheese, eggs, fish, meat, fresh vegetables and fruits. Drink plenty of fluids; fruit juices are very useful.

Other Post Hospitalisation Care

Regarding the episiotomy or perineal laceration stitches if the material applied for the stitches is absorbable; these do not have to be removed. In others, removal of stitches is usually done after 7days, before discharge from the hospital. Most maternity centres would give you the chance to see your baby as soon as you are out of the shock of labour and are relaxed and comfortable. This may take a few hours. Do not be apprehensive in loving him, cuddling him and above all in developing a kindly relationship with him right away. You may put him to the breast as well. In all probability, he is going to stay in a cradle by your beside-yes, right under your very nose. Do not neglect your diet. Take plenty of fluids and good nourishing diet if you want to regain your health and to successfully breast-feed your baby. Care of the breasts is of utmost importance. Always keep a good, well-fitting brassiere on. Attend to the cleanliness of the breasts. Also, learn how to manually express milk out of them. You may have to do it at one or another time, especially when gross engorgement of the breasts becomes a problem. Learn from the doctors and the nurses things which will stand in good stead to you and the baby once you are back home.

Care during Hospitalisation

Most Centres discharge the mother and the baby, if all is well, after 3 to 10 days. Going home as early as possible is now being increasingly encouraged. In the hospital room, where you are shifted after the delivery, you are supposed to take plenty of bed rest, including sleep, for 2 or 3 days. Then you will be allowed to sit at the side of the bed. If you wish, you may have a warm bath which, in fact, you should. In order to regain a normal figure, you must act on the doctor’s advice to start exercise while you are on the bed. He may want you to begin these on the very first day or a couple of days later. Gradually, the range of exercise is increased. The foot exercises will help you not to suffer from pain and aches in the feet which are invariably encountered after resuming activity at home. In the hospital, you must cooperate with the doctor and nurses who are regularly attending on you, taking care of medical problem, changing sanitary pads and making sure that superimposed infection does not occur. Constipation is common in the beginning. A mild laxative usually works but, at times, the doctor may advise an enema, which means injection of soap and water into the rectum.