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Lecture 9 - Lactation: Current Breast-Feeding Rates

The document discusses the benefits of breastfeeding for infants for the first 6 months of life. It provides information on breast anatomy, the stages of lactation and milk production, the hormonal regulation of lactation, and the composition and nutritional components of human milk including proteins, carbohydrates, fats, vitamins, and immune factors. Key points covered include the changes in milk composition over feedings and with the infant's age, current breastfeeding rates in the United States, and the role of prolactin and oxytocin in milk production and let-down.

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64 views5 pages

Lecture 9 - Lactation: Current Breast-Feeding Rates

The document discusses the benefits of breastfeeding for infants for the first 6 months of life. It provides information on breast anatomy, the stages of lactation and milk production, the hormonal regulation of lactation, and the composition and nutritional components of human milk including proteins, carbohydrates, fats, vitamins, and immune factors. Key points covered include the changes in milk composition over feedings and with the infant's age, current breastfeeding rates in the United States, and the role of prolactin and oxytocin in milk production and let-down.

Uploaded by

rachel o
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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Lecture 9 – Lactation

 Benefits of breastfeeding?
 Challenges to breast feeding today?
*All infants for the first 6 months of life need breast milk

Interesting Facts
 Composition of human milk can change over a single feeding, over a
day and according to the age of the infant
 The flavor of human milk changes –depends on moms diet
o Fetus also exposed to different flavors – amniotic fluid

Current breast-feeding rates


 2020 Goal - 82%
 Current 2015 - 79%
 1 year still breastfeeding current - 27%

#1 reason moms stop- is the worry/concern that the infant isn’t getting
enough breast milk.

Breast – Anatomy - Key Terms

Mammary gland- source of milk for the offspring. AKA breast

Alveoli- Rounded or oblong shaped cavity present in breast (contain cells that produce
milk)

Secretory cells- Cells in alveoli that are responsible for secreting milk components into
ducts.

Myoepithelial cells- Line the alveoli and can contract to cause milk to be secreted into
ducts

Lactiferous sinuses- Larger ducts for storage of milk behind the nipple

Lactogenesis- Term for human milk production. (production of milk)


Breast Development - Stages of breast development
1) in utero
- Begins in week 6 of embryogenesis
- Continues throughout gestation
- At birth, full formed with 15 – 25 lactiferous ducts

2) Adolescence
 Ductal growth throughout adolescence due to estrogen

 Alveolar lobes (mammary glands) after 1.5 years of menstruation

Lactogenesis

Preparation During Pregnancy:


Early to mid-pregnancy
 ductular sprouting, branching and lobular formation (placental
hormones)
 Colostrum –produced by 3rd trimester
Post-partum:
 Colostrum – produced first few days
 Milk production initiated due to prolactin production, and
decreased estrogen and progesterone after delivery of the
placenta
 Stimulation by infant sucking required to maintain milk
production

Stages of Lactogenesis
 Stage I – milk begins to form, lactose and protein content increases, first
few post-partum days, suckling not required

 Stage II – 2-5 days postpartum,  blood flow to alveoli, large in milk


production, first 10 days postpartum, suckling not required

 Stage III – Maintenance of milk supply, day 10 onwards, suckling required


Central Role of Prolactin and Oxytocin
1. *Prolactin- stimulates milk production (stimulates milk production)
 Suckling stimulates prolactin secretion
 Secreted from anterior pituitary

2. *Oxytocin (release of that milk)


 Ejects milk form the alveoli into milk ducts (let-down)
 Stimulated by suckling develops into a conditioned response
 Also acts on uterus and blood vessels
 Secreted from posterior

Secretion of Milk – Pathways

 Some components of milk made by secretory cells and secreted into


the ducts (lactose)

 Water, sodium, potassium and chloride pass through aveolar cell


membranes

 Milk fat comes from triglycerides in mom’s blood and fatty acids made
in the breast

Composition of Milk

Milk is a solution of proteins, sugars, salts and fats


 100 gram of human milk (65 cal)
 1g of protein (6% of calories)
 7.2 g of lactose (44%)
 3.6 g fat (50%) –breast milk high in fat
*remember the grams not percentages
Composition of Milk
-Colostrum
 Thick, yellow, fluid
 Produced days 1-3 after birth
 High concentrations of white blood cells from mom (provides immune
protection)
 Fist milk secreted during the first few days postpartum

Proteins
Caseins – Main protein in mature milk, helps calcium absorption

Enzymes
 Amylase – poly saccharide digestion
 Protease - protein
 Lipases – emulsifies milkfat, breaks down triglycerides to free fatty acids
and glycerol
- Also hormones and growth factors
- Low protein content – good for immature kidneys

Water-soluble vitamins
Responsive to the content of maternal diet
 Thiamin, Riboflavin
 Niacin
 Pantothenic acid
 Biotin, Folate
 B6, B12-Vegan moms (supplementation would be useful)
 Vitamin C

Cells
Raw breast milk contains cells which
Enhance resistance to infection by:
 Anti-bacterial action
 Production of antibodies
 Secretion of antibacterial products

Cells
 T and B lymphocytes (Only found in Human Milk)
 Protect against organisms in the GI tract
 B lymphocytes produce immunoglobulins
o Block the colonization of pathogens
o Limit the # of antigens that cross the mucosal barrier

*offers protection for the infant


Carbohydrates

Predominate CHO is lactose* important


Disaccharide galactose + glucose

High concentration – 40% of energy

130 different oligosaccharides


 Some known to simulate growth of bacteria and bind harmful bacteria.
(prevent infection and diarrhea)

Lipids (Fat)
*breastmilk is a high fat substance
Average content is low
3.9 g/100 ml (4% weight but 50% of energy)
 Higher in hindmilk than foremilk (rich in lactose)

Essential Fatty Acids must be derived from maternal diet


 Can be stored, but initially derived from diet
 Stored in adipose tissue and can be secreted into breast milk.
 EFA linoleic 18:2n-6 (omega 6)
linolenic 18:3n-3 (omega 3)

Essential Fatty Acids


 Humans have the capacity to synthesize longer chain (EPA and DHA) omega 3
fatty acids when they consume the precursor (the essential fatty acid alpha-
linolenic acid.

 Dietary sources can supply DHA

DHA (Docosahexaenioic Acid) – Omega 3 Fatty Acid


 Sources of DHA – Fish
 Flaxseed oil – rich in alpha linolenic acid (precursor to DHA)
 Important for brain and retina development in the infant
 DHA Added to some formula. Fat content*

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