17.05.2021

The formation of lactation, the battle for milk

Breastfeeding is an amazing form of interaction. This is not just a way for a newborn to get the food necessary for life and development, but also a dynamic two-way dialogue between the mother and child. When breastfeeding, there is a kind of information exchange and milk production with the composition that the baby needs at the moment. This is the strengthening of the psychological connection, which began to be laid even when the baby was in the womb.

Postpartum Lactation: Colostrum and Milk

Your breast milk is the best suited exactly for your baby: receiving information about the baby’s immune status from the saliva secreted by it, the mother’s body produces and transfers specific immunoglobulins with milk in response to the effects of bacteria and viruses that the baby is exposed to. These substances protect the baby, and if he gets sick, he will suffer the disease much easier than being on artificial feeding.

The woman’s body begins to prepare for milk production from the first months of pregnancy. The hormones progesterone and estrogen are responsible for this preparation. The breast increases in size already in the first trimester, its sensitivity increases, the nipples change shape, and the areoles darken to brown or become saturated red.

A few weeks or days before giving birth, women usually find that droplets of yellowish liquid stand out from their breasts. This is colostrum, it will be the food your baby needs in the first hours of his life and which he will receive for the first 3-5 days. In physical and chemical properties, it is very different from mature milk and in its composition is closer to blood. Colostrum is an important step in the transition from intrauterine nutrition to nutrition of mature milk.

Doctors recommend placing the baby in the chest during the first hour of life.

The first attachment to the chest. This natural action is of great importance both for the baby and for the mother – it gives a steady lactation. It is with the beginning of sucking that a signal comes to the woman’s brain about the need to feed the baby, which increases the production of the hormones oxytocin and prolactin, which stimulate lactation. The child remembers what and how to suck here. From about 3–8 attempts, the newborn manages to grab the chest correctly, after which he begins to suckle the chest with strong sips, periodically stopping briefly. Soon, he begins to forcefully compress his chest with his gums and squeeze out colostrum. The child himself determines how much time he needs to make it work, so you should not bother him and rush him. Usually he sucks at least one breast for at least 30 minutes and then releases it. Now he needs to be transferred to another breast, which he will also suck for a long time. When the baby copes with its task, he throws his chest and falls asleep.

Tsaregradskaya Zh.V. and Center “Rozhana”

Putting the baby to the breast immediately after birth triggers the mechanism of lactation

Useful properties of colostrum:

  • It contains few carbohydrates and fats and a lot of protein (about 14%), this is an ideal nutritional balance for the first days of a baby’s life.
  • It is easy to digest and has about two times more energy value than milk.
  • It has a mild laxative effect, which allows the newborn to get rid of the first stool without delay – meconium.
  • Covers the surface of the digestive tract and protects against infections thanks to IgA immunoglobulin.

The volume of the baby’s stomach in the first days of life is very small (about 5 ml), therefore, the colostrum of the young mother is not enough, literally a few drops at a time, they will completely saturate the baby . Some young mothers begin to worry, thinking that they may not have milk. These worries are in vain. Milk usually comes 3–5 days after birth in the primiparous and on 2–4 days in the multiparous. This process can be accompanied by an increase in body temperature up to 38 ° C, increased sweating and thirst. At this time, you need to monitor the amount of fluid consumed: drink no more than two liters per day, while avoiding hot and milk drinks, because they can stimulate excess milk production at this stage.

Sensation on arrival of milk

In a few days, the breast may increase by 1-2 sizes and milk will begin to produce much more than the newborn needs. This can be a rather painful process: a feeling of fullness and burning in the mammary glands appears, any movement or touch brings pain, and milk can spontaneously flow out of the chest, bringing relief. In some cases, the pain is unbearable, the breast increases significantly in volume, and the nipples are stretched and flattened due to this, blocking the exit of milk.

What to do to relieve the symptoms of milk
  1. Put the baby to the chest every hour and a half or more often.
  2. Take a cool shower, apply a cold compress to your chest. Take care not to get too cold.
  3. Reduce fluid intake; do not drink milk or hot drinks. To relieve thirst, you can dissolve small pieces of ice or drink cold water in small sips.
  4. Never squeeze or bandage your chest. Purchase a special nursing bra or elastic sports top that provides support without restricting blood supply.
  5. Do not sleep on your stomach and do not allow prolonged pressure on the chest during a night’s sleep, it can lead to stagnation of milk in one sector of the mammary gland. Inflammation of breast tissue with stagnant milk in them is called mastitis and sometimes requires antibiotics.
  6. Observe good hygiene practices. Use disposable or washable pads to collect leaking milk. They will ensure dry nipples, which will greatly help prevent their irritation and bleeding, which can also develop into inflammation and mastitis.
Gene areter pressure mitigation technique
  1. The fingers of both hands are placed on the areola, touching the tips of the fingers of the base of the nipple.
  2. Press the areola evenly and gently, pressing the chest with the pads of the fingers to the chest.
  3. Hold the pressure for 1-3 minutes. As a result, recesses 2.5-3 cm long will appear on both sides of the nipple.
  4. Turn your fingers around the nipple (like the clock hands), partially overlapping the first recesses, and repeat the pressure to soften the same area around the nipple.
  5. Repeat pressure in all segments of the areola, repeating as necessary and specially trying to create a depression in the place where the baby’s chin will be during feeding – for a deeper grip of the chest.
  6. If the edema is extremely strong and the areola tissue is very hard, continue pressing for an additional 1-3 minutes.
  7. To achieve a more uniform distribution of interstitial fluid, you can use two fingers to press the sectors alternately, in three or more sets of 60 seconds each.
  8. If the mother has one arm free, she can make a “hole” in the central part of the areola, grab the nipple and push the phalanges of her fingers on her chest for 1-3 minutes. You can then turn your hand at a different angle and repeat.

Lactostasis is stagnation of milk due to blockage of the excretory ducts of the mammary glands

For women who are facing such problems for the first time, it seems that this condition will never end, but it lasts about 2–5 days, after which the release of milk begins to adapt to the needs of the child.

Causes of lack of milk after childbirth and methods to combat the problem

Not all mothers manage to establish lactation after childbirth. Possible reasons:

  • Childbirth occurred by Caesarean section or emergency surgical intervention was required, or childbirth was initiated despite the absence of labor. The delicate balance of prolactin and oxytocin in the mother’s blood is disturbed, and this can lead to insufficient milk production or lack thereof.
  • The need to take a potent drug contraindicated in breastfeeding.
  • The critical condition of the child, in which his contact with the mother is impossible.

In most cases, lactation can be improved if you do not drag it for too long:

  • If mom still has colostrum and the baby is with her, it is necessary to apply it to her breast as often as possible so that the newborn receives the maximum amount of precious first milk.
  • If the mother is forced to take medicine and breastfeeding is contraindicated, she will have to temporarily transfer the baby to a carefully selected milk mixture, and the woman will need to use a breast pump to mimic the process of breastfeeding and stimulate lactation. It is necessary to decant according to the schedule, every 2–4 hours, including at night. Strained milk cannot be used, the whole point is to simulate the feeding process and stimulate the production of hormones responsible for milk formation.
  • If the newborn is not with his mother, but is able to eat, and his mother’s milk is not contraindicated, then the mother also expresses the milk and passes it to the medical staff for her baby.
Stages of lactation

The composition of milk varies significantly from day to day. This is due to the dynamically changing needs of a growing child, and the mother’s body must adapt to them in a timely manner.

Specialists distinguish three main stages in the formation of lactation:

  1. Colostrum. Its production begins in the last days of pregnancy and continues the first 3-5 days after birth.
  2. Transitional milk. At the age of 3-5 days, the baby needs more abundant feeding, he begins to ask for the breast much more often: sometimes even every half hour. Due to more frequent application, the mother’s body begins to develop real milk. In the process of this restructuring, your baby will receive the so-called transitional milk, and it will last 10-14 days until the production of mature milk is established. From the very name of transitional milk, it is clear that in terms of composition and function, it is conditionally located between colostrum and mature milk.
  3. Ripe milk. More caloric than colostrum due to the high content of fats and carbohydrates. It contains less protein. It, in turn, is divided into front and rear milk. The first is more watery, it stands out at the very beginning of the feeding process and allows you to quench the thirst of the baby, and the second is more fat and dense, it quenches hunger well. The exact moment when transitional milk is replaced by mature milk cannot be determined. For most mothers, these changes take about 15 days, plus or minus a week. Multiparous mothers who breast-fed their first babies also have a chance of more stable and reliable lactation, and due to experience, the difficulties of becoming this process are easier to overcome.

Colostrum, transitional and mature milk provide the baby’s needs at the stages of his growth

Lactation crisis

If you were with your baby from the very time of birth, put it on your breast in time, you got milk in excess, but after some time the baby began to miss it, do not get upset and lose hope for full breastfeeding. Most likely, this is due to another jump in the growth of the child. This is called a “lactational crisis”, the very first of which often occurs at the end of the second week after childbirth and lasts an average of 2-3 days.

There are many effective ways to restore and improve lactation in case of its insufficiency.

Here are some of them:

  1. Attach the baby to the chest as often as possible, keep it near the chest for as long as possible.
  2. Sleep with your baby.
  3. Eat plenty of balanced food.
  4. Do not forget to drink plenty of fluids, give preference to warm drinks and special lactogonous teas.
  5. To stimulate a rush of milk, a warm shower and a gentle massage of the breast will help.
  6. Consult your doctor: he can offer you safe and effective means of increasing lactation.
  7. Provide yourself with a favorable psychological background: get enough sleep, ask your relatives to help you with household chores, listen to pleasant music, take a relaxing bath and convince yourself that you will succeed.

If you have tried everything possible, but there are no results – before giving up, contact a certified breastfeeding consultant or a doctor you trust. They will help you gain confidence in yourself and, possibly, will point out mistakes that you do not notice.

If you have milk, but its quantity does not meet the baby’s needs, it is recommended to continue breastfeeding, while replenishing the missing nutrition by selecting a high-quality milk mixture that is suitable specifically for your baby.

The lack or complete absence of milk in no way suggests that you care poorly about your baby and do not have the right to be called a good mother. For a child, the main thing is the love and presence of parents, their care, sympathy and willingness to help. Give your child the best that is available to you, and that will be enough.

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