Breastfeeding

·        The breast consists of a mass of fat surrounding the glands and lactiferous ducts, and this mass is what determines the size of the breast.

·        Breast size has no relation to the ability to breastfeed.

·        The glands consist of milk alveoli lined on the inside with cells that secrete milk under the influence of the hormone prolactin (secreted from the anterior lobe of the pituitary gland).

·        The lactiferous ducts gather at the areola and are covered on the outside by muscle cells.

·        The muscle cells surrounding the mammary glands contract under the influence of the hormone oxytocin (secreted from the posterior lobe of the pituitary gland).

Reflexes and Hormones

·        Upon skin-to-skin contact between the baby and the mother before the first feeding, involuntary neural reflexes automatically appear, indicating the baby's desire to breastfeed.

·        These reflexes play an important role in the activation and maturation of the brain centers that lead to the newborn's proper attachment to the breast (widening of the mouth and good grasp of the areola to empty all lactiferous ducts in it).

·        Among the reflexes:

1.     Rooting reflex.

2.     Suckling reflex.

3.     Swallowing reflex.

·        The newborn discovers their way to the nipple using the "rooting reflex." When suckling begins, the sensitive nerve endings in the nipple area are stimulated, sending nerve signals to the pituitary gland to secrete prolactin and oxytocin (which is also secreted when thinking about the baby, hearing them cry, etc.).

·        The "suckling reflex" begins when the nipple touches the back of the roof of the baby's mouth. When the baby presses with their mouth (tongue) on the lactiferous ducts gathered under the areola, the milk is pushed into their mouth under the influence of the negative pressure formed at the back of the tongue.

·        This is followed by the "swallowing reflex," which allows breathing without interfering with the swallowing movement, so there is no obstruction to breathing, and thus the cycle of suckling, swallowing, and breathing is repeated.

·        The "relactation" process depends on the physiological reflexes of breastfeeding, which cause the activation of hormones responsible for milk secretion.

·        In the event that the alveoli and ducts are not emptied well of milk, the Feedback Inhibitor of Lactation is secreted, which reduces milk production. Therefore, the mother must be instructed to completely empty one breast in each feeding, alternating between the breasts during feeding. Therefore, the complete emptying of the ducts and alveoli of the breast is one of the most important factors for the continuation of milk supply.

"Skin-to-Skin" Contact Between Mother and Newborn

·        Ensures the success of the emotional bond between them.

·        In the mother, it stimulates the secretion of the hormone oxytocin, which leads to uterine contraction, reduces the sensation of pain, and generates maternal feelings and behaviors.

·        Activates a series of automatic neural reflexes that enable the newborn to crawl on its mother's chest until it finds the breast and latches onto the nipple and areola.

Diagram Highlights & Mechanisms

·        Oxytocin reflex: Causes contraction.

·        Prolactin reflex: Secretes milk under the influence of prolactin.

·        Key Anatomical Parts: Muscle cells, Milk-secreting cells, Ducts, Wide ducts, Nipple, Areola, Montgomery glands, Milk alveoli/glands, Fat cells and supporting tissues.

·        Hypothalamus and Pituitary Gland connection: Infant suckling at the nipple increases the secretion of the milk-producing hormone. Factors like confidence, thinking about the infant, love for the infant, and the sound of the infant help stimulate this reflex.

Clinical Importance of Breast Anatomy

·        The round shape of the breast allows for skin contact during breastfeeding.

·        The areola is characterized by high elasticity and therefore stretches during breastfeeding to reach the back of the mouth.

·        The tongue presses on the areola towards the roof of the mouth, pushing the milk.

·        The areola is distinguished by the presence of Montgomery glands, which are responsible for moisturizing the skin and secreting a scent similar to the amniotic fluid that surrounds the fetus inside the womb.

·        The nipple is highly sensitive as it is rich in peripheral sensory nerves that stimulate the hypothalamus and pituitary gland in the mother, thereby stimulating the brain reflexes for milk flow.