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12.physiology of Lactation
12.physiology of Lactation
12.physiology of Lactation
Prolactin level
but
Estrogen and Prolactin – inhibiting hormone
Suppress
The activity of Prolactin
contd…
- Sed Estrogen
helps
Progesterone for Proliferation of glandular tissue and
ductule development during pregnancy
- PCL, HCG, Human Chorionic Somato mammotropin
all contribute for mammary gland growth during
pregnancy
- At birth
Lactogenesis II continued
First secretes
Colostrum
Gradually replaced by
Transitional milk (3-10days)
-Dramatic hormonal changes
-do the tears
contd…
- In core temperature (engorgement)
by 10th day
Transitional milk replaced by Mature milk
Lactogenesis III:
-Called Galatopoiesis
-Begins 10 days after birth
-Mature milk contains about 22.5 calories /Ounce
Fore milk i) Produced and stored
-Mature milk between feeding
Hind milk ii) Released at the
beginning of next
i) Produced during feeding feeding
ii) Released at the end of iii) Appearance similar
feeding to skimmed milk
iii) Much richer iv) Characteristics blue
tinge
3) Lactation
- During weaning
contd…
ACTH (A.P.) -Necessary for maintenance
of Lactation
Thyroxine (Thyroid) -Important in maintaining
lactation
-Either by direct effect on
mammary glands
or
By control of metabolism
Thyrotropin releasing - Stimulates release of
Hormone Prolactin
(Hypothalamus) - To maintain established
lactation
Customs and Beliefs in relation to
Lactation
Customs / cultural Behaviours
Native American -Value the Traditional methods
Asian -Earlier generations breast fed second
generations Not breastfed delay in
Breast feeding or “Bottle and breast”
African -Bottle feeding-Status symbol
Hispanic -Belief that breast feeding is good
Americans -Artificial feeding is equalent to human milk
contd…
Mexican American -Colostrum is dirty or bad
don’t begin breast feeding at
birth
Beliefs
- Breast feeding is a learned art, woman must be motivated to
learn it
- 6 factors influence motivation to learn - Attitude
Felt need
Stimulation
Emotion
Competence
Reinforcement
contd…
-Some Erroneous beliefs about breastfeeding
experience
i) Breast feeding hurts
ii) Breast feeding will make the breast to sag
iii) I can’t breast feed because I didn’t prepare my
nipples
iv) I don’t want to breast feed because I don’t like to
drink milk
Responsibility of a Nurse /
Midwife
- Influence the attitude
- Who come with positive attitude requires positive
reinforcement
- Those who cane with negative attitude in need of
motivation
i) Confront wrong beliefs and assumptions attitude
ii) Or remove components of failure or fear
Birth injuries
Trauma during birth includes
i) Trauma to skin and superficial tissues
ii) Muscle Trauma
iii) Nerve Trauma
iv) Fractures
i) Trauma to skin and superficial tissues
a) Skin Trauma
- Cause is iatrogenic ie forceps blades, vacuum
extractor cups, scalp electrodes and scalpels
Cause Effect
1) Forceps blades Abrasion, bruising,
superficial fat necrosis
2) Vacuum extractor cups Abrasion
3) Scalp electrodes Puncture wounds
4) Caesarean section Laceration of the
baby’s skin
contd…
Nursing management
- Keep clean and dry wound
- Antibiotics
or sutures
b) Superficial tissues
- It involves edematous swellings or drwising or both
- During labour
Resting state
-During weaning milk changes is terms of
a) Its volume
b) Nutritional components
c) Immunologic properties
contd…
Suckling
Stimulates
Hormone Function