lecture 18: lactation Flashcards

1
Q

What is lactation?

A
  • primary source of nutrition and energy for newborn mammal
  • immune protection
  • mammary glands change - hormones and development
  • variation between species: e.g.
    • number of glands: human 2; wallaby 4; pig 18; cow 4 (apposed in single udder)
  • in a way lactation is the thing that characterises mammals
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2
Q

What is an example of variation in milk composition between species?

A
  • human:
    • water = 90 g/100mL
    • protein = 1.1 g/100mL
    • carbohydrate = 7.5 g/100mL
    • lipid = 4.2 g/100mL
    • energy (MJ/L) - 3.3
  • elephant seal:
    • water = 35
    • protein = 10
    • carbohydrate = 2
    • lipid = 55
    • energy = 23
  • elephant seals require more energy from the mother in order to survive the cold
  • the pups have to develop a thick layer of insulating blubber very quickly
  • dramatic differences between species that relate to environmental constraints and all sorts of other things
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3
Q

What is the structure of a mammary lobule?

A
  • e.g. cluster of alveoli in the goat
    • capillaries
    • venule
    • arteriole
    • myoepithelial cells
    • alveolar epithelial cells
    • alveolus
    • milk
    • milk duct
  • want to maximise surface area so there are a number of epithelial cells that can produce secretions → package into alveoli that are interconnected by milk ducts
  • these cells are very metabolically active
    • some high yielding dairy cows might produce two udders worth of milk a day → a lot of milk
  • fantastic vascular system
  • capillary beds surrounding each of the alveoli
  • huge amount of opportunity for exchange of nutrients between blood and epithelial cells
  • milk ducts coalesce in different lobules → down towards teat
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4
Q

What is the structure of mammary lobules and alveoli?

A
  • note vascular supply around alveolus
  • myoepithelial cells surrounding alveolus contract, increasing intra-mammary pressure at milk let-down
  • not just alveoli and blood vessels
  • connective tissue
  • ducts
  • adipose tissue → fat → most of human mammary tissue
  • pregnant women → mammary glands get bigger but the amount of fat probably stays the same
  • alveolus
    • secretory epithelial cells
    • surrounded by a cluster of cells called myoepithelial cells → flat, squamous sort of cells, muscle-like characteristics, respond to oxytocin
    • when you fill your alveolus with milk oxytocin causes contraction of myoepithelial cells → increases the intraalveolar pressure which squishes the milk out
    • highly specialised epithelium
    • basement membrane → gives structural support
    • specialised junctions between epithelial cells
    • milk is not just things from the blood oozing through leaky membrane
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5
Q

What are duct systems in different species?

A
  • rat
    • alveoli
    • lactiferous ducts
    • galactophore
    • nipple
  • rabbit
    • galactophore → multiple milk ducts ending on the teat
    • nipple
  • woman
    • lactiferious sinus
    • areola
    • nippe
    • 15 - 20 mammary lobes dilating as lactiferous sinus emerging at nipple
  • ruminant
    • galactophores
    • gland cistern → can get a lot of milk out very quickly
    • teat cistern
    • teat canal
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6
Q

How do mammary glands develop in the foetal mouse?

A
  • normal female → development of gland, nipple etc
  • ovariectomised female → mammary glands still differentiate therefore don’t need ovarian hormones to develop mammary gland
  • normal male → remnant of mammary gland, epidermis shows no sign of nipple formation
  • castrated male → development of mammary glands
  • androgens cause regression of the mammry primordia
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7
Q

What is postnatal mammary growth in rat?

A
  • pre-pubertal
    • atrophic ducts and very little mammary development
    • oestrogen + growth hormone → adrenal steroids →
  • pubertal
    • duct growth
    • oestrogen + progesterone + prolactin + growth hormone + adrenal steroids
  • post-pubertal
    • lobulo-alveolar growth
    • cyclic changes through oestrous/menstrual cycles
    • prolactin + adrenal steroids →
  • late-pregnancy → lactation
    • milk secretion
  • oestrogen, progesterone, cortisol, growth hormone, placental lactogen and prolactin needed for mammary growth during first pregnancy
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8
Q

What is the mammary gland cycle?

A
  • virgin → pregnancy → lactation → involution → pregnancy etc
  • duct structures in virgin female have little development
  • pregnancy → development
  • lactation → secretory etc
  • involution → milk production shuts down after relatively shuts down
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9
Q

Summary of structure and development of the mammary gland?

A
  • structure of mammary gland – variations on a theme
    • ducts and cisterns (cisterns can offload a lot of milk in a short time, helpful when you feed infrequently)
    • alveoli open into milk ducts
    • ducts join and empty via nipple or teats
    • galactophores are common ducts leading to teat: rabbits 6–8, man 15-20; agile wallaby approx. 20
    • supernumerary teats
  • foetal development
    • present in both sexes but poorly developed in men
    • regress in male mice and rats as a result of androgens
  • development after birth
    • full growth not achieved until end of puberty or in early lactation
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10
Q

How does hormonal regulation of milk secretion differ between species?

A
  • to maintain high milk production after removal of the pituitary gland:
    • rats need: prolactin, Adrenocorticotrophin (ACTH)
    • sheep and goats need: growth hormone, prolactin, ACTH, thyroptrophin
    • rabbits need: prolactin
  • ACTH maintains cortisol secretion from the adrenal gland
  • TSH maintains thyroid hormone secretion from the thyroid gland
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11
Q

What is the hormonal control of milk secretion?

A
  • mammary gland transplanted to the neck of a goat (Jim Linzell’s experiment)
    • separated from nerve supply
    • continued milk secretion
  • control is hormonal, not neural
  • however milk removal necessary for continued lactation (Malcolm Peaker)
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12
Q

What is the composition of breast milk at diffrent time points?

A
  • colostrum (onset of lactation)
    • high protein
    • rich in immunoglobulins
  • mature milk
    • 7% lactose
    • 4% fat
    • 1% protein
      • minerals, vitamins etc
  • two 25 mL samples of human breast milk
    • foremilk: the watery milk coming from a full breast
    • hindmilk: the creamy milk coming from a nearly empty breast
  • late pregnancy
    • high levels of progesterone, oestrogens
    • prolactin, hPL (hPL drops off dramatically at birth)
  • milk secretion turns on after birth, maybe a small amount before
  • prolactin stays high during lactation
  • sensory stimuli through teats
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13
Q

What are the hormones involved in pregnancy and peripartum in regards to lactation?

A
  • pregnancy → mammary gland development
    • high progesterone and oestrogens
    • hPL (hCS)
    • prolactin
  • peripartum → transition to lactogenesis
    • fall in progesterone and oestrogens
    • no hPL
    • slow fall in PRL → needs nipple stimulation (suckling) to maintain PRL and milk production
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14
Q

What is local regulation of lactation?

A
  • FIL - feedback inhibitor of lactation
  • small protein secreted in alveolus
  • if not removed by emptying alveolus, it acts to suppress further milk secretion
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15
Q

What are mammary secretory processes?

A
  • exocytosis: proteins made via RER and Golgi; lactose
  • apocrine secretion of lipids: vesicle membranes → phospholipids
  • trans-membrane: water; small molecules; drugs
  • trans-cytosis: immunoglobulins; some hormones and growth factors
  • paracellular: immune cells; leakiness may be high in disease states increasing transfer of interstitial fluids
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16
Q

What are the phases of lactation?

A
  • milk secretion
    • initiation of milk secretion begins in pregnancy
    • prolactin and other hormones
    • synthesis of milk constituents within alveolar cells
    • intracellular transport of milk componenets
    • discharge of constituents into alveolar lumen
    • local control – FIL
  • milk removal
    • passive removal of milk from cisterns and large ducts
    • stimuli
      • sucking
      • sights, smells, sounds, tactile stimuli associated with suckling
    • reflex ejection of milk from alveoli (‘let down’ or ‘draught’)
    • oxytocin
17
Q

What is the importance of sucking?

A
  • in milk secretion
  • sucking induced release of prolactin
  • prolactin
    • VIP = vasoactive intenstinal peptide
    • potent Prl releasing factor
  • dopamine from TIDA nerves
    • DA is a Prl release inhibitory factor
18
Q

What is the milk ejection reflex?

A
  • sucking-induced release of oxytocin
  • hypothalamus-hypophyseal tract: increased firing rate after nipple or reproductive tract stimulation causes increased oxytocin secretion
19
Q

What is the effect of anticipation of milking on oxytocin concentrations in cows?

A
  • PM: preparation for milking
  • MA: application of teat cups
  • S: stripping
  • C: control level
20
Q

What regulates the response to milk ejection?

A
  • oxytocin receptors
21
Q

What is the Hottentot method of inducing milk let down?

A
  • Ferguson Reflex → oxytocin positive feedback in uterine contractions
22
Q

What is the hormonal control of lactation?

A
  • consists of milk secretion and milk removal stages
  • maintenance of lactation usually requires several anterior pituitary hormones
  • prolactin is critical in non-ruminants, and growth hormone in ruminants
  • oxytocin essential for milk ejection
  • milk removal essential for continued lactation
  • responses mediated by receptors
23
Q

How does milk composition changes?

A
  • changes in peripartum period
  • milk composition in women pre- and post-partum
  • 0 indicates time of birth
24
Q

What are variances in milk composition?

A
  • colostrum: post-partum secretion high in protein, sodium and chloride
    • also antibodies (IgG and IgA)
  • milk: large species differences in concentrations of milk fat, lactose, protein and water
  • milk fat mixture of lipids: triglycerides, diglycerides, monoglycerides, free fatty acids, phospholipids and sterols
  • arctic, aquatic, desert mammals produce milk with 75% energy in lipid fraction
  • frequent nursing species produce milk with lower nutrient density
25
Q

What is lactation in marsupials?

A
  • milk composition changes in marsupials
  • high in carbohydrates early
  • middle levels of proteins and lipids
  • ultimately high in lipids, v low in carbohydrates
  • protein levels remain similar
26
Q

What is milk ejection in the agile wallaby?

A
  • concurrent asynchronous lactation
  • difference in response to OT allows milk ejection in gland with PY continuously attached
  • sucking by young at foot causes ME in both glands
27
Q

What is prolactin related suppression of reproductive cycle?

A
  • dopamine and agonists (bromocriptine) inhibit prolactin synthesis
  • high levels of prolactin in lactation inhibits GnRH
  • pituitary LH response to GnRH reduced, failure of positive feedback
  • ovarian response to LH same
  • naloxone (opiate inhibitor) also inhibits prolactin release (alternate pathway)
28
Q

What are the contraceptive effects of breastfeeding?

A
  • cumulative % probability of pregnacy
    • non-lactating, no contraception → relatively high even immediately post partum
    • lactating, no contraception
      • low initially, increases
    • post partum, lactating + post menstrual contraception
      • low with v moderate increase
  • monthly % risk of pregnancy vs months of lactational amenorrhoea
    • increases with time
  • contraceptive effects of extended periods of lactational amenorrhoea
29
Q

What is the lactational control of reproduction?

A
  • prolactin release important in suppressing cyclic release of gonadotrophins
  • endogenous opiates (beta endorphins) are also involved
  • frequency of suckling very important in lactational amenorrhoea
30
Q

summary

A
  • nutrition, energy, water, immune protection for newborn
  • mammary gland has multiple lobules
    • alveoli → secretory epithelium
    • myoepithelial cells → OT and milk ejection
    • well vascularized
  • development induced by hormones - prolactin, Prog, E2 etc
  • placental lactogens in pregnancy
  • initially colostrum (immunoglobulins) → mature milk
  • oxytocin and Fergusson reflex + CNS
  • lactation control of reproductive cycles - role of endorphins
    • anoestrus
    • diapause