Written by : Dr.M.D.Mazumdar, MD

The breasts increase greatly in size during pregnancy as they prepare for the important function of feeding the baby after childbirth.

The ducts and glands proliferate in size, the blood supply increases and more fat gets deposited around the glandular tissue. The breast acini, which are small threadlike cells, develop into larger cells, fully capable of producing milk from the mother's blood. So, the breasts are also called the Accessory Organs of Reproduction.

Initiation of Breastfeeding

The World Health Organisation WHO recommends early initiation of breastfeeding (i.e. within one hour of giving birth) .

The breasts begin to secrete a thin yellowish fluid called the colostrum in the later weeks of pregnancy. Colostrum is also secreted during the first 3-4 days after delivery. It is ideal as the baby's first food since it contains all the various food ingredients in the right proportion for easy digestion.

It is necessary to feed the baby often during this stage as the amount of colostrum secreted is less in amount.

Actual milk formation and secretion starts from the 3rd-4th day of the postpartum period. The breasts may become engorged, tense and tender when the milk first comes in, but once regular suckling is established, the breast engorgement passes off.

The Let Down Reflex of Breastfeeding

The Let down reflex occurs when a baby is put to the breast. The baby's suckling stimulates minute nerve endings in the nipples. These send a reflex to the pituitary gland which responds by secreting two important hormones - oxytocin and prolactin.

Prolactin causes milk to form in the alveolar cells in the breast from the circulating blood. Oxytocin contracts the cells to push out the milk through the nipples

Somce women feel pain in the breast when the let down reflex starts. others may feel a tingly sensation. Most have no symptoms at all.

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Positions for Breastfeeding

The baby can be fed in more than one position to distribute the suckling pressure - the different positions are shown in the images below. The mother should choose whichever position she finds most comfortable.

Importance of Breastfeeding

• Best Nutrition: Breastmilk is nutritionally the most suitable food for the newborn baby. The colostrum contains large amounts of antibodies that protect the baby against infections. The proteins, fats and carbohydrates in the milk can be easily digested by the baby. The mother's milk also contains additional substances like iron and Vitamin A which can be effectively absorbed.

• Protection against Allergy: In families with a history of allergic conditions like Bronchial asthma, the breastfed baby gets antibodies from the mother that can provide protection against the causative allergens.

• Psychological Benefits: Studies have shown that a breastfed baby grows up into a secure and emotionally stable adult.

• Development of Intelligence: Studies have shown that a breastfed baby can have a higher IQ - upto an eight-point difference - than a bottlefed baby. Fatty acids critical for neurological development are present in a better digestible form in breastmilk than in artificial mlk.

• Protection for the Mother: Breastfeeding protects the mother against breast cancer and uterine cancer later in life.

• Weight loss: A mother who breastfeeds her baby can lose weight faster and more efficiently than a mother who uses the bottle to feed her baby.

• Economical: Breastfeeding is economical in the long run as it cuts down on illnesses suffered by both the baby and the mother.

Birth Control

Breastfeeding is not reliable as a contraceptive measure for birth control. Even if a woman is exclusively breastfeeding, there is a always a chance that she will ovulate during this period and become pregnant.

Women who are breastfeeding should not take birth control pills containing estrogen. Estrogen can affect the quality and quantity of the milk. The risks for blood clots are also high in the first 4 weeks after birth of the baby. If at all a birth control pill is needed, then progestin only pills like the Minipill should be taken.

Sore Nipples/Cracked Nipples

The nipples can crack at the tips if the baby fails to latch on properly while breastfeeding. Too dry nipples, or inverted nipples are particularly prone to this problem. Sometimes yeast can get into the cracks and cause an infection - this will worsen the pain and the woman may not be able to breastfeed. The breast can become engorged and painful.

The standard treatment is to apply an anti-yeast medicines to the breast. Anti-yeast suspension should also be painted inside the baby's mouth to prevent recurrence of the infection.

It may also be necessary to avoid breastfeeding at this time from the affected breast. The excess milk should be pumped out. Breastfeeding can be resumed once the soreness decreases.

Production of milk continues as long as suckling continues. It starts to decrease when breastfeeding stops and may stop completely in 4 - 6 months after stopping breastfeeding. But the breast will start producing milk again if suckling occurs again at any time of the woman's life.

Also Read-

• What birth control method is best after childbirth?
• Breast Abscess after childbirth.
• Vaginal Discharge with Itching .
• Complications in the Postpartum period after Childbirth.