Lactation process in women

How is milk produced?

The main hormones that are responsible for the production of breast milk in women are prolactin and oxytocin.

Prolactin plays an important role in milk production. On days 2-5 after birth, the amount of this hormone in the blood increases significantly, the breasts become fuller, and milk appears in it. The amount of prolactin directly depends on the baby's sucking and how often the mother puts the baby to the breast. The more often and more actively the baby suckles, the higher the prolactin level and the greater the amount of milk.

The second hormone, oxytocin, determines the release of milk. It stimulates the contraction of muscle cells near the alveoli and helps remove milk into the milk ducts. The level of oxytocin in the blood also depends on the baby’s sucking activity, as well as on the mother’s emotional state. Discomfort and pain during feeding, as well as depression, reduce the production of oxytocin.

Meaning of the word lactation

(from Latin lacto ≈ I contain milk, I feed with milk), the process of formation, accumulation and periodic excretion of milk in humans and mammals. L. begins after childbirth. Only mammary glands that have passed a certain stage of development during pregnancy can secrete. Milk is formed in the epithelial (secretory) cells of the alveoli of the mammary gland from the components of the blood. There are 4 stages of milk: absorption of “precursors” of milk from the blood by the mammary gland; synthesis of milk components in the secretory cells of the gland; formation and accumulation of synthesized products inside the cytoplasm of secretory cells; separation of milk into the cavity of the alveoli and other containers of the mammary gland (for example, the so-called cistern). Milk proteins are synthesized from amino acids, milk sugar - lactose - from glucose, milk fat - from neutral fat and free fatty acids in the blood. In the regulation of lactose, the main role belongs to the hypothalamus and pituitary gland. During pregnancy, lactogenic hormone begins to be released in large quantities; the hormone of the posterior lobe of the pituitary gland - oxytocin - is also involved in the process of milk production.

L. in humans. On the first day after birth, you can express just a few drops of colostrum from the mammary glands. Subsequently, the increase in secretion occurs in different ways; in some cases the amount of milk gradually increases, in others the flow of milk occurs suddenly, violently. Women (mainly primigravidas) sometimes experience late appearance of milk; secretion begins only on the 5th-6th day and even at the beginning of the 2nd week, slowly developing by the 3rd week. From the moment milk flows in, secretion gradually and continuously increases, reaching a maximum between the 10th and 20th weeks and remains at this height until the end of L. The amount of breast milk in the same woman on different days and different hours of the same day may be subject to fluctuations (after a night's rest there is more milk, after a sleepless night, at the end of the day, after hard work there is less milk), but in general it is approximately the same within a day. If the mammary gland has good lactation capacity and the woman is feeding two or more children, L. can reach 2000≈3000 g per day.

Good nutrition of the mother is necessary for good L. A nursing woman should receive an average of 110≈130 g of protein, 100≈130 g of fat and 450≈500 g of carbohydrates; vitamin A ≈ 2 mg, riboflavin ≈ 3.5 mg, nicotinic acid ≈ 25 mg, pyridoxine ≈ 4 mg, ascorbic acid ≈ 100≈120 mg per day. The nursing mother should consume an increased amount of liquid ≈ up to 1.5≈2 liters (depending on the volume of milk secreted). An obligatory part of the diet should be milk (but not more than 0.5 l) and dairy products (cottage cheese, etc.), meat, fish, eggs.

Of the L. disorders, the most common is hypogalactia ≈ a decrease in L. The complete absence of milk secretion ≈ agalactia ≈ is observed very rarely and occurs as a result of hormonal disorders. Sometimes there is a spontaneous flow of milk from the mammary gland outside or during feeding of the child, which does not occur due to the abundance of milk, but as a functional disorder of the mammary glands in women with increased nervous excitability. Apart from general strengthening agents, it does not require special treatment. A decrease in L. is observed in all chronic debilitating diseases of the mother (diabetes, nephritis, cancer, etc.), in acute diseases that occur with high fever and loss of appetite (for example, mastitis), in chronic infections (especially tuberculosis), and also in diarrhea. . Medicines taken by a nursing mother have little effect on L., although it can decrease under the influence of laxatives, diuretics, camphor, atropine and some others.

L. in animals increases during the first time after birth, then gradually decreases. A cow produces the greatest amount of milk at the end of the first and second month after calving. In some animals (cows, mares, goats), L. decreases with a new pregnancy. To obtain higher milk yields in the next season, cows stop milking 1.5–2 months before calving (dry period), and mares and goats stop milking even earlier. The time from the beginning of L. after childbirth to the cessation of milk secretion is called the lactation period. Its duration: on average 300 days for a cow, ≈ 8–10 months for a goat, ≈ 4–5 months for a sheep, ≈ 9 months or more for a mare, ≈ 60–70 days for a pig. The duration of the pregnancy period and the amount of milk obtained from the animal depend on the type, breed, feeding and maintenance, the timing of the new pregnancy and the duration of the dry period. L. disturbances are observed with mastitis, involuntary leakage of milk, and stiffness. See also Udder.

Lit.: Espe D., Milk secretion, trans. from English, M., 1950 (bib.); Emelyanov A.S., Lactation activity of cows and its management, Vologda, 1953; Grachev I.I., Reflex regulation of lactation, L., 1964; Azimov G.I., How milk is formed, [2nd ed.], M., 1965; Neurohormonal regulation of lactation, M. ≈ L., [1966].

Stages of lactation

First stage

The first stage of the lactation process is the appearance of colostrum. During pregnancy, women's breasts change. Adipose tissue turns into glandular tissue, which is where milk will be formed in the future. After 28 weeks of pregnancy, the glands begin to produce colostrum. This is a translucent, slightly yellowish liquid that contains a large amount of immunoglobulins.

In the first days, while the milk has not yet arrived, the woman feeds the baby with colostrum. It helps strengthen the child’s immunity and also prepares his digestive system for the absorption of milk. It is important to start breastfeeding your baby immediately after birth.

Second phase

The second stage of lactation is the arrival of milk. If the birth took place on time, then colostrum is replaced by milk 2-5 days after the birth of the baby. The first flow of milk may be accompanied by fever and breast swelling. If you feel a rush, put your baby to your breast more often. This will be a good prevention of the formation of lumps in the breast and will contribute to successful lactation.

Third stage

The third stage is mature lactation. It can occur between 3 weeks and 3 months after birth. This depends on the type of birth the woman had, as well as on the individual characteristics of the body. The period of mature lactation is characterized by the absence of milk flows; its production occurs more gradually and is adjusted to the baby's sucking regime. Between feedings, women's breasts become softer.

Many mothers at this time begin to fear that the baby is not getting enough milk. There is no need to be afraid of this, since the main production now occurs during the baby’s active sucking. The stage of mature lactation lasts up to 2-2.5 years.

Final stage

The final stage of lactation occurs physiologically when the baby turns 2.5 years old. At this age, the child already eats many different foods in addition to mother's milk, and breastfeeding becomes more of a psychological process. The composition of milk changes, it becomes similar to colostrum. It contains a lot of immunoglobulins, leukocytes, and phagocytes, which fully meets the needs of an older child.

Milk production gradually decreases. When a woman completely stops feeding her child, a final restructuring of the body occurs. The breast becomes soft, milk can be squeezed out of the nipple with difficulty. The opposite process occurs to what happened during pregnancy: the volume of glandular tissue decreases, and it is replaced by a fatty layer.

Characteristics

Lactation in women is the production of milk in the breast, its release during pregnancy and feeding the newborn. This process begins before the baby is born, but has no specific end date. Depending on the intensity of feeding, this period can last for 3 years. However, it also happens that a woman’s breasts stop producing milk a month after the birth of the child. This causes a number of problems and difficulties in feeding a newborn, so mothers resort to many ways to stimulate milk production.

The production and production of breast milk in women is prepared by the female body during pregnancy. It is customary to divide the lactation period into several phases:

1. The initial stage or mammogenesis is a monthly preparation of the body for the feeding period, breast enlargement due to the accumulation of biological substances in it (colostrum).
2. Lactogenesis is the process of breastfeeding when all the biochemical components of colostrum become milk suitable for the baby. Fully occurs after the birth of the child.
3. Lactopoiesis is the main period in lactation when the body has fully adapted and supports the production of full-fledged mature milk for feeding.

Of the many biochemical substances that affect the mother's nursing body, two main hormones are distinguished, the content of which determines the production of nutrients and their concentration in the mammary glands.

• Prolactin is the main protein hormone, the creation of which is responsible for the pituitary gland. Accumulating in the alveoli, it affects the production of nutritional components by the mammary glands. Like a “switch,” prolactin gives the command to action. Its concentration in the blood promotes the processing of colostrum into finished milk.
• Oxytocin is the second important hormone that promotes contraction of the muscle tissue of the nipple, as a result of which milk is released from the veiny currents outward. Its production depends on the emotional state of the woman, her feelings towards the child, as well as the newborn’s breast sucking reflex.

How to increase lactation

There are a number of methods that can improve the process of breast milk production. This can be done either naturally or with the help of medications. Doctors and lactation consultants recommend using medications only when it is not possible to establish lactation naturally.

The main methods for increasing lactation are:

• a balanced diet for the mother, which includes at least 2 liters of fluid per day and excludes harmful foods from the diet;
• feeding process: correct and frequent breastfeeding;
• an orderly daily routine and proper rest for mom;
• breast massage and contrast shower.

The lactation process is an important and necessary period in the life of mother and child. Breast milk contains all the nutrients, microelements and vitamins necessary for the baby. No adapted milk formulas can fully replace it. Therefore, breastfeeding is necessary for the normal development and growth of the child.

Problems during breastfeeding

During normal functioning, milk production is based on the baby's needs. The more and more often the feeding process occurs, the stronger the mammary glands work. This affects the duration and intensity of the lactation period. However, the lactation period may not always proceed smoothly. Sometimes there are disturbances in the lactation cycle, up to its complete disappearance. This is associated with many factors related to both the physiology and the psyche of the mother.

One of the problems may be the late lactation period. The delay is explained by insufficient hormonal levels or problems in its functioning, resulting in a lack of milk production. The lack of necessary hormones, such as estrogen and prolactin, reduces or stops the functioning of the mammary glands, causing premature involution - the cessation of the lactation process in the woman’s body.

Another reason may be the mental background of the nursing mother. Any nervous tension, stress or psychological trauma can negatively affect the functioning of not only the mammary glands, but also the entire body, including the immune system. This also affects the biological composition of breast milk, its saturation with nutrients and microelements.

Another factor in lactation disruption is physiological disturbances or damage. For example, blockage of the mammary glands due to irregular secretion of milk and its stagnation in the breast, improper attachment of the child to the breast during feeding, which causes cracks in the nipple.

During this period, it is especially important for a nursing mother to monitor her health, tone and body needs, since they determine the quality and quantity of nutrients.

Lactation

I

Lactation (lactatio; lat. lac, lactis milk)

secretion of milk from the mammary gland. The full lactogenesis cycle includes several interrelated processes: mammogenesis—the development of the mammary gland; lactogenesis—the formation of milk in the secretory cells of the mammary gland after childbirth; lactopoiesis—the development and maintenance of milk secretion.

The formation and development of the mammary gland (Mammary gland) begins from the 10th week of intrauterine development. In the postnatal period, as the body grows and matures, further development of the mammary gland occurs. The mammary glands reach full morphological maturity during pregnancy (Pregnancy). Growth and development occur mainly under the influence of the hormones of the pituitary gland (prolactin), ovaries (estrogens and progesterone), as well as placental hormones (placental lactogen). Already from the 2-3rd month of pregnancy, hyperplasia of the glandular parenchyma of the mammary gland begins and its secretion begins; expansion and proliferation of the milk passages and significant development of the alveoli of the mammary gland are observed. The mammary glands reach their greatest development at the time of birth.

The formation and excretion of milk after childbirth is determined by a complex mechanism of neurohormonal regulation. The activity of the mammary gland is regulated by the cerebral cortex and hypothalamus, which determine neurohormonal effects on the pituitary gland, which produces prolactin and oxytocin, necessary for the formation and secretion of milk. After childbirth, due to the cessation of the function of the fetoplacental system in a woman’s body, the level of estrogen and progesterone decreases, and the level of the lactogenic hormone prolactin increases. The hormone oxytocin, produced in the hypothalamus, enters the bloodstream and then into the myoepithelial cells of the mammary gland, regulating milk excretion. Due to a decrease in hormonal secretion of the ovaries, menstruation during lactation is usually absent (physiological lactational amenorrhea).

During the first two days after birth, squeezing the nipples may produce a small amount of colostrum, which is immature milk. The quantity of milk gradually increases and the composition of milk changes, and from the 2-4th week after birth, the mammary glands secrete mature milk (see Breast milk). The daily amount of breast milk reaches its maximum values ​​(usually 1-11/2 l) by the 8-9th week after birth. With normal function of the mammary glands, the daily amount of milk secreted corresponds to the child’s needs, which is determined by the Finkelstein formula, volumetric and other methods (see Feeding children).

For the development and maintenance of milk secretion, rhythmic and fairly complete emptying of the mammary glands (sucking, expressing milk) is of great importance. The mammary glands are very sensitive to the influence of external and internal environmental factors, which is due to the complex neurohormonal regulation of their functions. L. largely depends on the state of somatic and mental health, constitution, age, nutritional characteristics of the postpartum mother, as well as understanding of the benefits of breastfeeding. L. usually fades away by the end of the first year of the child’s life and completely disappears after the child is weaned.

Pathology. Possible absence (agalactia), decrease (hypogalactia) and increase (hypergalactia) of the secretory function of the mammary glands after childbirth, as well as spontaneous leakage of milk from the mammary glands (galactorrhea).

Agalactia is very rare. It is caused mainly by the congenital absence of glandular elements of the mammary glands; less often occurs due to physical exhaustion or severe mental shock; when these factors are eliminated, L. can recover.

Hypogalactia is observed in 8-10% of postpartum women. Depending on the level of decrease in milk secretion, 4 degrees of hypogalactia are distinguished. With I degree, milk deficiency is no more than 25%, with II degree - 26-50%, with III degree - 51-75%, with IV degree - more than 75%. Hypogalactia can be diagnosed already on the 5-6th day after birth, because During this period, there is a high positive correlation between the daily amount of milk and the functional activity of the mammary gland.

There are early (in the first 10 days after birth) and late (10 days after birth), primary and secondary hypogalactia. Primary hypogalactia is a consequence of functional inferiority of the mammary gland caused by genetic factors or hormonal disorders in a woman’s body (for example, diabetes mellitus). Secondary hypogalactia can occur in women who have suffered complications of pregnancy (for example, late toxicosis, anemia), childbirth (for example, pathological blood loss) and the postpartum period (for example, postpartum infectious diseases); after obstetric operations (caesarean section, etc.); for general infectious and somatic diseases, malnutrition, physical and mental stress of a woman; violation of breastfeeding rules; decreased sucking reflex in a child; due to the use of certain medications (vitamins B6, camphor, ergot alkaloids, preparations of estrogenic and androgenic hormones, etc.), as well as exposure to harmful production factors.

It is necessary to establish the cause of hypogalactia and, if possible, eliminate it. To normalize L., oxytocin, ascorbic acid, and nicotinic acid are recommended. Oxytocin is prescribed intramuscularly at 0.5 or 1 ml (2.5 or 5 units) 2 times a day before feeding the child, 20-30 minutes before the injection it is recommended to administer 1 ml of a 2% solution of no-spa intramuscularly, the course of treatment is 5 days . Ascorbic acid is used 0.3 g 2 times a day orally for 10 days, nicotinic acid - 0.05 g 2 times a day orally 10 minutes before feeding the child for 10 days. Sedatives are also indicated. Nonspecific methods of influencing the body as a whole are used (for example, physical exercises, water procedures, etc.), as well as local physiotherapeutic procedures (sollux, ultrasound, low-intensity UHF, vibration massage).

Prevention of hypogalactia comes down to eliminating the causes that contribute to its development. It includes the prevention and rational treatment of complications of pregnancy and childbirth, ensuring proper nutrition of the pregnant and postpartum women, compliance with the child’s feeding regimen; rhythmic and complete emptying of the mammary gland; prevention of postpartum infectious diseases, restriction of medications.

Hypergalactia may be associated with excessive excitability of the nervous system or with increased secretion of prolactin; the daily amount of milk can reach 4-5 L in some lactating women. For hypergalactia caused by hyperprolactinemia, bromocriptine (parlodel) is used, which inhibits the synthesis of prolactin. If a prolactin-secreting tumor of the pituitary gland is detected, treatment usually begins with the prescription of bromocriptine, and surgical and radiation treatment is performed according to indications (see Pituitary adenoma).

Galactorrhea. Sometimes (as a rule, with increased excitability of the woman’s nervous system), spontaneous flow of milk from the mammary gland is observed when the baby is applied to the other mammary gland. Normalization of the daily routine, psychotherapy, and general strengthening measures are recommended.

Spontaneous leakage of milk may be a consequence of hyperprolactinemia, which can develop in women after stopping breastfeeding (Chiari-Frommel syndrome) or occurs outside of pregnancy and childbirth in a number of pathologies. conditions (see Galactorrhea - amenorrhea syndrome).

Bibliography: Bodyazhina V.I. Obstetric care in antenatal clinic, p. 239, M., 1987; Dedov M.I. and Melnichenko G.A. Syndrome of persistent galactorrhea - amenorrhea, M., 1985.

II

Lactation (lactatio; lat. lacto, lactatum to contain milk, to breastfeed)

secretion of milk from the mammary gland.

Pathological lactation (l. pathologica) -

1) L. in men with true gynecomastia;

2) L. in women, not associated with pregnancy or breastfeeding.

Source: Medical Encyclopedia on Gufo.me

Meanings in other dictionaries

1. Lactation - (from Latin lacto - I contain milk, I feed with milk) the process of formation, accumulation and periodic excretion of milk (See Milk) in humans and mammals. L. begins after childbirth. Great Soviet Encyclopedia
2. LACTATION - LACTATION, the production of milk by female MAMMALS for feeding their young. In a pregnant woman, HORMONES promote breast enlargement, and PROLACTIN (a HORMONE produced by the PITUITARY Gland) stimulates breast cells to produce milk. Scientific and technical dictionary
3. lactation - Lactations, plural. no, w. [from Latin. lacto – breastfeeding] (physiol.). 1. Secretion of milk in female mammals. 2. The period of breastfeeding the baby. Large dictionary of foreign words
4. Lactation - See Milk. Encyclopedic Dictionary of Brockhaus and Efron
5. lactation - LACTATION (from Latin lacto - I contain milk, I feed with milk), the formation and accumulation of milk in the mammary glands of women. mammals, as well as periodic its elimination during sucking or milking. Veterinary encyclopedic dictionary
6. lactation - LACTATION (from Latin lacto - I feed with milk) in agricultural. animals, the formation and accumulation of milk in the udder, as well as its removal during sucking or milking. Agricultural Dictionary
7. lactation - spell. lactation, -and Lopatin's Spelling Dictionary
8. lactation - -i, f. physiol. The secretion of milk by the mammary glands (in female mammals), as well as the period during which this process occurs. [From lat. lactare - contain milk; feed with milk] Small academic dictionary
9. lactation - Lactation, lactation, lactation, lactation, lactation, lactation, lactation, lactation, lactation, lactation, lactation, lactation, lactation Zaliznyak’s Grammar Dictionary
10. lactation - noun, number of synonyms: 1 hyperlactation 1 Dictionary of synonyms of the Russian language
11. lactation - LACTATION -i; and. [from lat. lactare - contain milk, feed with milk] Physiol. The process of formation and secretion of milk by the mammary glands (in female mammals); the period during which this process occurs. ◁ Lactation, -aya, -oe. L. period. Kuznetsov's Explanatory Dictionary
12. lactation - The formation of milk by the mammary glands of female mammals and its release during sucking or milking. The activity of the mammary glands during lactation is regulated by the cerebral cortex, hypothalamus, and pituitary gland. Biology. Modern encyclopedia
13. lactation - LACTATION, lactation, pl. no, female (from Lat. lacto - breastfeeding) (physiol.). 1. Secretion of milk in female mammals. 2. The period of breastfeeding the baby. Ushakov's Explanatory Dictionary
14. lactation - LACTATION, and, g. (specialist.). The formation and secretion of milk in women and female mammals. | adj. lactation, oh, oh. L. period. Ozhegov's Explanatory Dictionary
15. lactation - (from Latin lacto - I feed with milk), the formation and accumulation of milk in the mammary glands of women. mammals and its periodic excretion during sucking or milking. Biological encyclopedic dictionary
16. lactation - lactation f. 1. The process of formation and secretion of milk in the mammary glands of women and female mammals. || The result of such an action. 2. The period of time during which such milk secretion occurs. Explanatory Dictionary by Efremova
17. lactation - Lact/atsi/ya [y/a]. Morphemic-spelling dictionary
18. LACTATION - LACTATION (from Latin lacto - I feed with milk) - the formation of milk in the mammary glands and its periodic excretion. Characteristic of female mammals and women. Begins after childbirth under the influence of hormones; If milk is not removed from the gland, lactation stops. Large encyclopedic dictionary

• Blog
• Jerzy Lec
• Contacts
• Terms of use

© 2005—2021 Gufo.me