Female Breast Flashcards
What are the female breasts/mammary glands?
Accessory organs of reproduction that are required to provide nourishment for the neonate after birth
Modified exocrine glands
What do the mature female breasts consist of?
One areola which provides lubrication during lactation
One nipple which milk is excreted
Many alveoli which milk is produced in
Tubules and ducts which the milk passes through
Describe the external structure of the breast
Situated either side of the midline of the anterior chest wall
Extend from 2nd to 6th rib, laterally from the sternum to the axilla.
Over pectoralis muscles where they are attached by connective tissue
Hemispherical in shape
Breast size varies
Midpoint of exterior surface lies the areola average measurement of 2.5cm diameter
Degree of pigmentation varies
Nipple at centre of areola, erectile, sensitive
What are Montgomery tubercles?
Sebaceous glands that secrete sebum like substance to lubricate the nipple during pregnancy and breast feeding
Describe the internal structure of the breast
16-20 lobes divided by bands of fibrous tissue
Each lobe has a lactiferous duct which leads to a lactiferous sinus (reservoir) beneath the nipple where the milk is stored
Each lobe divided into lobules which contains a lactiferous duct where milk is directed from the alveoli
Variable amounts of adipose tissue around the breast
Alveoli are clustered around lactiferous ducts
Alveoli are composed of milk secreting cells - acini cells
Myoepithelial cells enclose alveoli to contract under influence of oxytocin squeezing milk into the lactiferous ducts
What are acini cells?
Cells that extract nutrients necessary for milk production from the network of capillaries that surround the alveolus and produce milk.
Describe the blood, lymph and nerve supply to the breast
Blood supplied by mammary arteries and upper intercostal arteries
Venous drainage into the mammary and axillary veins
Lymphatic drainage is extensive and is into the axillary glands and some drainage into the mediastinal glands
Little nerve supply to the breasts however they are largely controlled by hormones
Skin is supplied by branches of the thoracic nerves from the 2nd-6th intercostal muscles
Nipple and areola supplied by autonomic nervous system
How do the breasts change in pregnancy?
Week 6- enlargement in response to increasing hormones oestrogen responsible for growth of lactiferous ducts and tubules, progesterone prolactin and human placental lactogen result in enlargement and proliferation of the alveoli
Increased sensitivity to touch and tingling feelings
Increased blood supply mean visible veins on surface
Week 12- nipple and areola become more pigmented, Montgomery tubercles become pronounced and secrete lubricants
Week 16- colostrum formed, high levels of oestrogen and progesterone prevent it from being secreted
Week 24- secondary areola form, areas of pigmentation around the areola
Average 5cm enlargement, 1500g weight increase
What is colostrum?
Precursor of milk
Highly nutritious and contains immunoglobulins which help protection against infection in the newborn
Immediately available to the neonate after birth
Yellow colour
Higher protein content than breast milk
High proportion of immunoglobulins
Carbohydrate and fat levels are lower than in breast milk
How does labour effect the breast?
Once third stage is compete, placenta and many hormones are no longer in the body resulting in dramatic decrease in oestrogen and progesterone which initiates lactation
How do inverted nipples effect breastfeeding?
Ultimately they do not
Can be reassured that the baby attaches to more than the nipple during attachment and therefore he or she can pull the nipple out themselves during suckling
How is the production of milk started?
Oestrogen and progesterone levels decrease and prolactin increases stimulating lactation
Suckling of the neonate (stimulation) causing colostrum to to change in composition to milk
Discuss the importance of skin to skin contact
Midwives responsibility
BFI UNICEF
Place the naked neonate on its mothers bare chest immediately after birth
If left undisturbed the baby will exhibit behaviour conducive of successful breast feeding as well as maintaining its body temperature
What are the two main hormones involved in lactation?
Prolactin- anterior lobe of e pituitary gland influences the production of milk
Oxytocin- from the posterior lobe controls the ejection of milk
How are prolactin levels influenced?
Suckling
Frequent breast feeding
Including night feeds
