Aleli P.

Ludovico

2013 - 72482

Patricia Isabel K. Ramos

2013 - 68086

HNF 22 U-3L

March 4, 2016

Exercise 4
HOW BREASTFEEDING WORKS?

Breastfeeding is the feeding of babies and young children with milk from a womans
breast. It offers many benefits to the growing baby wherein proper nutrition is being provided.
(NIH, 2015). To successfully help mothers, it is necessary to have a knowledge on how
breastfeeding works. The anatomy and physiology of breastfeeding are essential to fully
understand the process.
In this paper, the following concepts were discussed:
1. main parts of the breast and their function;
2. hormonal control of breast milk production and ejection;
3. difference between good and poor attachment of a baby at the breast; and
4. difference between effective and ineffective suckling.

The breast is the tissue overlying the chest muscles. Women's breasts are made of fatty,
specialized tissues and parts with different functions that are mainly for milk production. In a
breast, the dark skin around the nipples is called the areola. In the areola are small glands called
Montgomery's glands which secrete an oily fluid to keep the skin healthy. Inside the breast are
the alveoli, which are very small sacs made of milk-secreting cells.
Around the alveoli are muscle cells, which contract and squeeze out the milk. A hormone
called oxytocin makes the muscle cells contract. Small tubes, or ducts, carry milk from the
alveoli to the outside and is stored in the alveoli and small ducts between feeds. The larger ducts
beneath the areola dilate during feeding and hold the breast milk temporarily during the feed.
For the control of breast milk production and ejection, the major hormones involved are
prolactin and oxytocin which are both produced by the pituitary gland as a response to the signal
sent by the suckling of the infant. Prolactin is the hormone being secreted during and after feed
to produce the next feed. Prolactin goes in the blood to the breast, and makes the milk-secreting
cells produce milk. The more a baby suckles the more milk the breasts produce. Oxytocin, on the
other hand, makes the muscle cells around the alveoli contract and makes the milk which has
collected in the alveoli flow along the ducts to the larger ducts beneath the areola. Here the milk
is stored temporarily during the feed which is defined as the oxytocin reflex, the milk ejection
reflex or the let-down reflex. If this reflex doesnt work well, a difficulty to the baby in getting
the milk may happen wherein the breasts are still producing milk but it is not flowing out. The
oxytocin reflex is easily affected by a mother's thoughts and feelings, good feelings for
stimulation and bad for hindering the reflex.

Moreover, breastfeeding can also be influenced by the attachment of the breast to the
infant. Good attachment follows the following key points:
1. More areola above babys top lip than below bottom lip
2. Babys mouth wide open
3. Lower lip turned outwards
4. Babys chin touches breast
Poor attachment may cause different unnecessary changes such as sore nipples, fissures
or cracks and engorgement that may lead to less production of milk affecting the milk intake of
the baby. To prevent this, all mothers need skilled help to position and attach their babies.
There are three main reflexes in the baby the rooting reflex, sucking reflex, and
swallowing reflex. In the rooting reflex, when something touches the lips, the baby opens mouth,
puts tongue down and forward. In the sucking reflex, when something touches the palate, the
baby sucks. In the swallowing reflex, when the mouth of the baby fills with milk, the baby
swallows. All these reflexes happen automatically without the baby having to learn to do them. It
is an innate skill where the mother learns to position the baby and the baby learns to take the
breast.

REFERENCES
National Institute of Child Health and Human Development. 2015. Breastfeeding. Retrieved
March 3, 2016 from https://www.nlh.gov/medlineplus/ency/article/002452/htm

World Health Organization. 2006. Infant and Young Child Feeding Counselling: An Integrated
Course. Participants Manual. Retrieved March 2, 2016 from
http://www.who.int/nutrition/publications/IYCF_Participants_Manual.pdf