Lactating Mother

Normally from the fourth month of pregnancy a woman's body produces hormones which stimulate the growth of milk ducts. By the fifth or sixth month of pregnancy, the breasts are ready to produce milk. How does a lactating mother cope with the problems that might arise? Will a lactation consultant help? This article takes you through the process of lactation and the benefits it affords to a newborn.

What is lactation ?

The lactation process begins in a mother when the hormone oxytocin is produced in response to the birth of a new baby. Both uterine contraction and lactation process more or less begin simultaneously. The milk produced is primarily controlled by the hormone prolactin, which relies upon the length of time the infant nurses at the breast.

Significantly, lactation provides the much needed nutrition for the new born baby. The first milk a breast fed baby receives is called colostrum which contains high amounts of white blood cells and antibodies than mature milk. This colostrum is rich in immunoglobulin A. This helps to coat the lining of the baby's immature intestines. Germs trying to enter the baby's system are also prevented. Food allergies are also kept away. After the initial two weeks, colostrum gives way to mature breast milk.

Hormones influencing Lactation

• Progesterone influences the growth of alveoli and lobes. It is observed that progesterone levels normally drops after childbirth, thereby triggering milk production aplenty.
  
  
• Milk duct system gets stimulated with estrogen which drops at the time of delivery and continues to remain low for the first couple of months of breast feeding. This is the reason why feeding mothers are recommended to avoid estrogen based birth control methods as this would reduce a mother's milk production.
  
  
• Oxytocin helps contract the smooth muscles of the uterus during and after birth. After birth, this contraction squeezes the newly produced milk into the duct system. More importantly, oxytocin is essential for milk ejection reflex and let-down to occur.
  
  

Evolution of breast milk

Lactogenesis I:

This is the stage during the latter part of pregnancy when the breasts produce colostrum which is a thick yellowish fluid.High levels of progesterone inhibit most of the milk production.

Lactogenesis II:

This is the stage of copious milk production due to abrupt withdrawal of progesterone after the delivery of the placenta. The high prolactin levels stimulate the milk production.

Lactogenesis III:

This is the most controlled stage of milk production when the supply is firmly established. The more milk is removed from the breasts, the more the breast will produce milk. Much depends on how the baby feeds and how it is able to transfer milk from the breast.

Induced lactation

It is sometimes possible in a woman who has never been pregnant to induce enough lactation to breastfeed. This is called 'induced lactation'. This is how adoptive mothers breastfeed. The fact is if a woman's nipples are consistently stimulated by either a breast pump or suckling, the breasts have the capacity to produce enough milk to enable her feed the baby.

Lactation tends to adjust according to the demand.Significantly, there is little or no significance in the composition of the breast milk whether the lactation is induced or natural. Drugs, especially atypical anti psychotics such as Risperdal causes lactation in both women and men.

Breast milk production

Feeding or expressing the milk more frequently definitely increases the supply of milk. But it happens that when babies undergo a 'growth spurt' the level of supply seems to suddenly become inadequate.

A well-rested mother promotes a good let-down reflux which is essential for good milk production. It is imperative that feeding mothers pay enough attention to their diet as a nutritious diet with adequate protein facilitates milk production. The normal reasons for low supply of breast milk are:

• Not pumping enough milk
  
  
• Inability of the infant to transfer milk effectively; this could be due to deficit in the jaw and mouth of the baby, digestive inability of the infant, poor latching technique, maternal endocrine disorders, hypoplastic breast tissue, and inadequate calorie intake/malnutrition of the mother.
  
  

Diet tips for the lactating mother

Certain substances in the mother's diet could enter the milk and reach the child's stomach. Keeping this factor in mind, a lactating mother has to plan her diet very well. Three glasses of milk daily is essential for the health of both the feeding mother and the suckling baby.

Lactating mothers should well be aware of the fact that any food that causes indigestion and does not suit the mother's system will affect the infant and cause diarrhea, stomach ache, cold and other ailments.

Adequate consumption of pulses, vegetables and milk must be ensured for proper lactation. In general sour foods and cold drinks could be avoided.

According to the National Institute of Health, lactating mothers need 1,500 mg/day of calcium. It is necessary to pay attention to this fact in the diet. The lactating mother can consume medicine only on medical advice as these could reach the child and cause irreparable damage.

Breastfeeding Benefits

• Reduced risk of cancer in breast, ovaries, and uterus
  
  
• Natural contraceptive. Breastfeeding induces delay of fertility
  
  
• Faster postpartum recovery. Breastfeeding uses up additional calories so it is easier to lose their pregnancy weight
  
  
• Nursing a baby helps the uterus shrink
  
  
• Relaxation. Breastfeeding induces the body to produce oxytocin, a hormone that induces a sense of calm satiation.
• Protection from osteoporosis
  
  

Breast milk is the ideal food for an infant. It has all the necessary contents such as:

• Fats: Human Breast milk contains omega 3 fatty acids so essential for the growth and development of the brain. The milk at the beginning of the feeding is called the foremilk. It is a low fat milk.
  
  
• The hindmilk that comes at the end contains higher concentrations of fat. Thus a longer duration of nursing results in proportionately higher fat intake for the baby
  
  
• Proteins: The whey proteins found in breast milk are inherently easier to digest than other milk. Taurine - the amino acid responsible for the development of brain is in human milk but not in Cow's milk.
  
  
• Sugars: Breast milk contains lactose which provides energy to the infant. Human milk contains 20%-30% more lactose than cow's milk.
  
  
• Vitamins and minerals: Nature has specifically designed the composition of milk based on the needs of the species. Thus the human milk provides the most balanced source of vitamins and minerals for an infant.
  
  
• Immune system boosters: White blood cells and immunoglobulins are responsible for warding off potential infections
  
  

A mother of a new born may need certain advice or assistance on breast feeding. In such cases a lactation consultant should be of help. She can provide the lactating mother with proven tips and techniques to enable milk flow freely.

Such a lactation consultant is specially trained to assist breast feeding mothers. Lactation consultants need not necessarily be certified, but normally they are licensed practical nurses who are professionals and have completed nurse training with a license to help mothers breast feed.

• Breast feeding as such is a challenging task. Sometimes coupled with emotional trauma and milk supply issues, is becomes even more indomitable to handle especially for young mothers. A qualified lactation consultant can help through such difficult times and render the much needed emotional support and advice to get the breast milk flowing freely and regularly.
  
  
• A lactation consultant or a suitably trained health care professional may advise on several techniques that could be used to increase the supply of milk. She shall advise on switching of breasts during feeding times, either to feed from both breasts, or switch back and forth during feeding time.
  
  
• A mother could be advised to use breast pump in increase the supply of milk when not feeding the baby.
  
  
• Supplements could be used (Milk thistle or Fenugreek) to induce, augment and maintain lactation.