Anatomy of the Breast and Physiology of Breastfeeding

Question 1

What are the 3 stages of Lactation?

Answer 1

Lactogenesis 1, 2 and 3.

Question 2

What is Lactogenesis 1?

Answer 2

Breast development and colostrum production from approximately 16 weeks gestation.

Question 3

What is Lactogenesis 2?

Answer 3

Onset of copious milk secretion, occurring between 32 and 96 hours after birth.

Question 4

What is Lactogenesis 3?

Answer 4

Maintenance of milk production.

Question 5

What are the lobules (alveoli) of the breast?

Answer 5

Clusters of specific glands that produce milk when a woman is lactating

Question 6

What is the Lactiferous Duct?

Answer 6

It carries the milk secreted by the lobules through the breast tissue to open at the nipple.

Question 7

What are Montgomery’s Tubercles?

Answer 7

They appear on the areola and secrete a sebum to lubricate the area and to entice the baby to the breast. This sebum is also antiseptic.

Question 8

What are Lactocytes?

Answer 8

Milk producing cells (Acini cells).

Question 9

What are Myoepithelial cells?

Answer 9

Cells which squeeze the milk down ducts.

Question 10

During pregnancy, the ductal system and alveolus develop under the influence of which hormones?

Answer 10

Oestrogen, Progesterone and hPL.

Question 11

What are the 2 main breastfeeding hormones?

Answer 11

Prolactin and Oxytocin.

Question 12

What is prolactin responsible for?

Answer 12

Milk Production

Question 13

What is Oxytocin responsible for?

Answer 13

Milk Ejection

Question 14

What is the Prolactin Response?

Answer 14

Baby suckles at breast
Sensory impulses pass from nipple to brain.
Prolactin is secreted from anterior pituitary and goes via bloodstream to breasts
Acini cells then produce milk

Question 15

What is the Prolactin Receptor Theory?

Answer 15

As baby suckles and brain releases prolactin, the prolactin primes receptor cells to switch on and become acini cells. The more early frequent surges of prolactin there are, the greater the number of receptor sites will be primed, This maximises long term milk supply.

Question 16

What is the Oxytocin reflex?

Answer 16

Baby suckles at breast
Sensory impulses pass from nipple to brain
Oxytocin secreted by posterior pituitary goes via bloodstream to breasts.
Myo-epithelial cells contract and expel milk into lactiferous ducts. This is known as ‘Let Down Reflex’.

Question 17

What is Feedback Inhibitor of Lactation (FIL)?

Answer 17

It is produced by lactocytes. As the alveoli distend, there is a build up of FIL and milk synthesis is inhibited. When breastmilk is effectively removed, FIL levels will fall and milk synthesis will increase.

Question 18

What are the benefits of skin to skin?

Answer 18

Calms baby
Regulates baby’s heartrate, respiratory rate and temperature
It stimulates the baby to seek the breast
Prepares mother for mothering.

Question 19

What are the benefits of breastfeeding for babies?

Answer 19

Protects against;

Gastroenteritis
Respiratory infections
Allergies
Obesity
Type 1 and 2 Diabetes
Ear Infections
Urinary Tract Infections
NEC
SIDS

Question 20

What are the benefits of breastfeeding for mothers?

Answer 20

Protects against;

Breast Cancer
Ovarian Cancer
Hip Fractures
Heart Disease
PP Haemorrhage
PND

Question 21

Name some of the constituents of breastmilk that are not found in formula.

Answer 21

Growth Factors
Lymphocytes
Stem Cells
Immunoglobulins
Leukocytes
Oliggosaccharides

Question 22

What is high in density and low in volume?

Answer 22

Colostrum

Question 23

What are the changes in the breasts during pregnancy?

Answer 23

At 4 weeks, many women experience tingling and tenderness.
At 12 weeks increase in size of breasts - may appear marbled.
At 13 weeks areola and nipple may darken and enlarge, Montgomery’s tubercles become noticeable.
At 16 weeks, some women will start secreting colostrum.

Question 24

Name 4 common challenges of breast feeding.

Answer 24

Sore nipples. Thrush. Engorgement. Mastitis.

Question 25

What is mastitis?

Answer 25

Inflammation of mammary glands. Often caused by build up of milk within the breast. This is known as mill stasis. This can occur because of;

Baby not attaching properly
Baby having problems sucking
Infrequent or missed feeds
In some cases, this build of milk can also become infected with bacteria, This is known as infective mastitis.

Question 26

What hormone is responsible for growth of milk producing cells in glands?

Answer 26

Progesterone

Question 27

What hormone is responsible for growth of duct cells?

Answer 27

Oestrogen

Question 28

What is the Bifidus Factor?

Answer 28

Found in breastmilk, it enhances growth of bifidobacteria in the intestines.

Question 29

In which ways do midwives support the physiology of lactation?

Answer 29

Unhurried skin to skin contact after birth until baby has had first feed
Calm, relaxed environment with minimal disruption
Support and encourage responsive feeding
Plenty of reassurance for mother
Support positioning and attachment
Teach mothers to hand express if required.

Question 30

What are the health promotions in relation to breastfeeding?

Answer 30

Education - Benefits of skin to skin, exclusive breast feeding, breastfeeding groups. positioning and attachment, involving and educating partners and wider support network.
Empower mother to take control of own health needs.
Social change - support breastfeeding in public.