Breast Feeding

From Encyclopedia of Sex and Sexuality

The female breast is a mammary gland, or milk-producing organ. Each mature mammary gland is composed of fifteen to twenty-five separate lobes, that are arranged radially and further subdivided. The alveoli, or milk producing units, are provided with small ducts that join others to form a single large duct for each lobe. These ducts make their way to the nipple and open separately to its surface.

The hormonal and neural mechanisms involved in lactation (milk production) are complex. Prolactin, a hormone secreted from the protutan gland, is essential for lactation. Other hormones, such as progesterone, estrogen, cortisol, and insulin, act in concert with prolactin and are important as well. Regular sucking by the infant causes contractions within the ducts, which eject milk through the nipple and stimulate further milk production. In this way the amount of milk production is regulated by the infant’s needs.

Most women and infants are physically capable of breast-feeding provided they receive sufficient encouragement. Breast-feeding should begin as soon after delivery as the conditions of the mother and baby permit, preferably within several hours. The mother’s diet should contain enough calories and vitamins to compensate for those secreted in her milk or those required for its production. Weight reduction diets should be avoided by nursing mothers.

Breast-feeding has four main benefits for the infant:

• The composition of breast milk is ideally suited for the nutritional requirements of the infant. Recently, hormones and enzymes have been identified in breast milk and these are also thought to promote the infant’s growth;
• Breast milk contains antibodies that provide protection against common causes of infant infections. The first milk (colostrum) has anti-inflammatory properties;
• Breast milk diminishes the likelihood of the infant devloping allergies by reducing his or her exposure to foreign, nonhuman proteins such as those found in cow’s milk;
• Breast-feeding promotes a passive psychological interaction and bond between the mother and the infant.

Breast-feeding declined in most industrialized countries from the 1940s to the early 1970s, when less than 30 percent of mothers breast-fed their infants at one week of age. The main reasons were the difficulties faced by working mothers and the relative convenience offered by infant “formulas” that substituted for breast milk. In the 1970s, when the benefits of breast-feeding were emphasized, a marked reversal of the trend was observed, and about 60 percent of mothers were breast-feeding their infants at one week of age. Most studies suggest that lactating women have additional energy requirements. It is generally recommended that a breast-feeding woman eat about a quarter more than is recommended for a non-pregnant woman. This is especially true for women who did not gain adequate weight during pregnancy. Increased consumption of milk products is not necessary during lactation. In fact, a woman’s body can make milk out of any food, provided it contains the essential nutrients.

Infant sucking can initiate milk flow within ant hour after delivery, although in most cases milk will not flow heavily. Sucking during these first hours also reinforces uterine contractions, which reduce uterine bleeding. Subsequently, frequent sucking is necessary to maintain milk flow, and no restriction on feeding times should be imposed. If the baby is fed on demand, its hunger regulates the amount of milk production.

The size of a woman’s breasts does not affect the ability to breast-feed, but depressed or inverted nipples may cause lactation problems that require medical attention. At each feeding both breasts should be offered, each for five to fifteen minutes, and the baby should start on a different side each time. If the mother is nursing from only one breast, the other breast will become engorged and milk production will decrease. Breast engorgement is normal for three to seven days after delivery and can be a source of some discomfort. Gentle milk expression and a nursing brassiere for support are helpful. Tender nipples are common when the baby begins sucking. Sore nipples can be avoided by proper positioning and short sucking episodes. In some cases, nipple creams can be used and manual milk expression and infant feeding with a spoon can be used alternatively. In rare instances, inflammation of the breast occurs and medical attention becomes necessary.

Infant weighing before and after each breast-feeding may provide an indirect measurement of milk intake.