<< Chapter < Page Chapter >> Page >

When the infant suckles, sensory nerve fibers in the areola trigger a neuroendocrine reflex that results in milk secretion from lactocytes into the alveoli. The posterior pituitary releases oxytocin, which stimulates myoepithelial cells to squeeze milk from the alveoli so it can drain into the lactiferous ducts, collect in the lactiferous sinuses, and discharge through the nipple pores. It takes less than 1 minute from the time when an infant begins suckling (the latent period) until milk is secreted (the let-down). [link] summarizes the positive feedback loop of the let-down reflex    .

Let-down reflex

This figure shows the process of let down reflex, the process in which the brain receives sensory impulses to release the hormones necessary for producing and discharging milk to the suckling newborn.
A positive feedback loop ensures continued milk production as long as the infant continues to breastfeed.

The prolactin-mediated synthesis of milk changes with time. Frequent milk removal by breastfeeding (or pumping) will maintain high circulating prolactin levels for several months. However, even with continued breastfeeding, baseline prolactin will decrease over time to its pre-pregnancy level. In addition to prolactin and oxytocin, growth hormone, cortisol, parathyroid hormone, and insulin contribute to lactation, in part by facilitating the transport of maternal amino acids, fatty acids, glucose, and calcium to breast milk.

Changes in the composition of breast milk

In the final weeks of pregnancy, the alveoli swell with colostrum    , a thick, yellowish substance that is high in protein but contains less fat and glucose than mature breast milk ( [link] ). Before childbirth, some women experience leakage of colostrum from the nipples. In contrast, mature breast milk does not leak during pregnancy and is not secreted until several days after childbirth.

*Cow’s milk should never be given to an infant. Its composition is not suitable and its proteins are difficult for the infant to digest.
Compositions of Human Colostrum, Mature Breast Milk, and Cow’s Milk (g/L)
Human colostrum Human breast milk Cow’s milk*
Total protein 23 11 31
Immunoglobulins 19 0.1 1
Fat 30 45 38
Lactose 57 71 47
Calcium 0.5 0.3 1.4
Phosphorus 0.16 0.14 0.90
Sodium 0.50 0.15 0.41

Colostrum is secreted during the first 48–72 hours postpartum. Only a small volume of colostrum is produced—approximately 3 ounces in a 24-hour period—but it is sufficient for the newborn in the first few days of life. Colostrum is rich with immunoglobulins, which confer gastrointestinal, and also likely systemic, immunity as the newborn adjusts to a nonsterile environment.

After about the third postpartum day, the mother secretes transitional milk that represents an intermediate between mature milk and colostrum. This is followed by mature milk from approximately postpartum day 10 (see [link] ). As you can see in the accompanying table, cow’s milk is not a substitute for breast milk. It contains less lactose, less fat, and more protein and minerals. Moreover, the proteins in cow’s milk are difficult for an infant’s immature digestive system to metabolize and absorb.

The first few weeks of breastfeeding may involve leakage, soreness, and periods of milk engorgement as the relationship between milk supply and infant demand becomes established. Once this period is complete, the mother will produce approximately 1.5 liters of milk per day for a single infant, and more if she has twins or triplets. As the infant goes through growth spurts, the milk supply constantly adjusts to accommodate changes in demand. A woman can continue to lactate for years, but once breastfeeding is stopped for approximately 1 week, any remaining milk will be reabsorbed; in most cases, no more will be produced, even if suckling or pumping is resumed.

Mature milk changes from the beginning to the end of a feeding. The early milk, called foremilk    , is watery, translucent, and rich in lactose and protein. Its purpose is to quench the infant’s thirst. Hindmilk is delivered toward the end of a feeding. It is opaque, creamy, and rich in fat, and serves to satisfy the infant’s appetite.

During the first days of a newborn’s life, it is important for meconium to be cleared from the intestines and for bilirubin to be kept low in the circulation. Recall that bilirubin, a product of erythrocyte breakdown, is processed by the liver and secreted in bile. It enters the gastrointestinal tract and exits the body in the stool. Breast milk has laxative properties that help expel meconium from the intestines and clear bilirubin through the excretion of bile. A high concentration of bilirubin in the blood causes jaundice. Some degree of jaundice is normal in newborns, but a high level of bilirubin—which is neurotoxic—can cause brain damage. Newborns, who do not yet have a fully functional blood–brain barrier, are highly vulnerable to the bilirubin circulating in the blood. Indeed, hyperbilirubinemia, a high level of circulating bilirubin, is the most common condition requiring medical attention in newborns. Newborns with hyperbilirubinemia are treated with phototherapy because UV light helps to break down the bilirubin quickly.

Chapter review

The lactating mother supplies all the hydration and nutrients that a growing infant needs for the first 4–6 months of life. During pregnancy, the body prepares for lactation by stimulating the growth and development of branching lactiferous ducts and alveoli lined with milk-secreting lactocytes, and by creating colostrum. These functions are attributable to the actions of several hormones, including prolactin. Following childbirth, suckling triggers oxytocin release, which stimulates myoepithelial cells to squeeze milk from alveoli. Breast milk then drains toward the nipple pores to be consumed by the infant. Colostrum, the milk produced in the first postpartum days, provides immunoglobulins that increase the newborn’s immune defenses. Colostrum, transitional milk, and mature breast milk are ideally suited to each stage of the newborn’s development, and breastfeeding helps the newborn’s digestive system expel meconium and clear bilirubin. Mature milk changes from the beginning to the end of a feeding. Foremilk quenches the infant’s thirst, whereas hindmilk satisfies the infant’s appetite.

Questions & Answers

how can you remember the integumentary system
Naomi Reply
integumentary system is the skin the skin is protection all the body and contain deid cells
Drs
how can you remember the formation of bone?
Maame
the largest organ of the body
Toni
skin is largest organ
Zara
what is the best way to remember the cranial bones or any other bones ?
Savannah
skeletal system?
Savannah
look at the diagram structure and then remember it considering it your own body i memorise like that
Zara
hi guys! do you have to remember ALL the structures of the bones- I mean every single hole, depression or tuberosity?
Kristina
tuborisity
Zara
hey guz i hv to remember Immune antibodies and antigens how? i found it difficult
Zara
well, they are all grouped, aren't they? I mean they all come in series like H1, H2A, H2B and so on. In this case I learn the common part first and then that what's different
Kristina
nd what about IgG , IgE etc.
Zara
the majors
Toni
blood is a connective tissue which transport oxygen and other nutrients to body
Zara Reply
which type of protein is blood?
Zara
what is blood?
Masthan Reply
blood is a connective tissue which transport oxygen and nutrients to body
Zara
which type of protein is blood?
Zara
haemoglobin
Rashid
and what about its structure i think its Quartenary structure 🤔💭
Zara
yes it is
Rashid
it is globular
Rashid
a vascular structure compose of vessels.
Toni
what is the functions of lymph
moula Reply
what is plasma
Chukwu Reply
A plasma is a hot ionized gas consisting of approximately af a equal number of positive ly charged ionized and negative ly charged electron is called plasma.
Muhammad
what is an atomical position?
Madinatu
military position, body erect where by the body will be up straight..the cephalic and thoracic are straight
Mwita
functions of plasma membrane
Dinyando Reply
what is heparin
Lawrence Reply
why is it anatomy
Tenacious Reply
hello
ASIMENU
hi
asare
hws life
Tenacious
anatomy is the scientific study of the body's structure
Lawrence
great
Lawrence
good night
Kaaya
anatomy is the study of form, physiology is the study of function
Patrick
anatomy is the study of the structure of the body and the physical relationship between it constituent part
Florence
what is heparin
Lawrence
what is the trunk
Tenacious
trunk is define as a person's or animal's body apart from the limp and head
Lawrence
The trunk is part of the axial skeleton
Patrick
hellow friends
mickson
hi friends
mickson
Hi
REEMA
hii
sampath
hi
Inayat
am fine
Ematai
supine or dorsal position is used in clinical setting when patient is placed in position, to examine what?
Dinyando Reply
what do nurses/doctors detect when a patient is placed on dorsal position?
Dinyando
What is coroid process?
kelvin Reply
describe special situation with implications in medical ethics.
kelvin
what is the difference between anatomy and physiology
Dinyando Reply
anatomy is the study of human body . and physiology is the study of the brain
Maryiam
ok
Varun
hi friends
Varun
hi!
kelvin
hello
Maryiam
anatomy is the study of the human body,its form and it physical relations Whiles Physiology is the Study of the functions of the various part of the body
Madinatu
yes
Yeboah
hi friends
mickson
sorry I cant see the full question
Jessica Reply
what was the question?
evelyna
what is spine as a bone marking?
John
similar to a crest but raised more
evelyna
pointed process
evelyna
slender
evelyna
pointed projection i meant
evelyna
what fills the hallow space in the middle of bones? thanks
John
marrow
evelyna
bone marrow
evelyna
hey you gotta read a book
evelyna
i just happen to take this bone chapter in my book last week so i remember
evelyna
yeah i should. how about the correct match of the number of tarsal, metatarsal and phalanges?
John
10, fingers and toes, u know this
Patrick
what is the difference between basal laminal and basal membrane
Nartey Reply
I think they r the same
Patrick
If one is missing the opsin which detects wavelengths of approximately 560 nm what color would they be unable to see?
Alicia Reply
how do I explain into details the epithelial tissue
Sir Reply
Epithelial tissues line the outer surfaces of organs and blood vessels throughout the body, as well as the inner surfaces of cavities in many internal organs. An example is the epidermis, the outermost layer of the skin. There are three principal shapes of epithelialcell: squamous, columnar, and cub
DJ
thank you
Sir
explain how the intestinal irritation results in diarrhoea
Sir

Get the best Anatomy & Physiology course in your pocket!





Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
Google Play and the Google Play logo are trademarks of Google Inc.

Notification Switch

Would you like to follow the 'Anatomy & Physiology' conversation and receive update notifications?

Ask