How breastmilk is produced?

The female breast is the gland that produces milk. The female breast begins to prepare for lactation with the onset of puberty. As a woman matures there is a further mammary development giving a characteristic structure to the breast. During pregnancy , the glandular cells of the breast change into actual secreting cells. By the time the baby is born, the breast reaches a degree of development capable of producing milk.

Let's understand how milk is actually produced.
The breast consists partly of gland tissues and partly of supporting tissues and fats (Fig. 3).The gland tissue (technically known as alveoli) are small sacs, made up of

millions of milk secreting cells which goes along small tubes towards the nipple. Before they reach the nipple, the tubes become much wider, and form lactiferous sinuses in which milk collects. The nipple contains many sensory nerves so it is very sensitive. This is important for the responses which help milk to come. Around the nipple there is a circle of dark skin called areola. Beneath the areola are the lactiferous sinuses. Therefore, areola must go inside the baby's mouth in order to draw milk from sinuses.

How breastmilk flows and reaches your baby?

Every time your baby suckles at the breast, he stimulates the nerve ending in the nipple.These nerves carry message to the brain,which makes a hormone called prolactin. The prolactin goes in the blood to the breast and them secrete milk for this feed and the next feed.Prolactin works after the baby suckles ,and makes milk for the next feed. These events from the stimulation of the nipple to secretion of milk are called the milk secretion response, or prolactin reflex (Fig. 4). It is very

important to understand the effect of suckling on milk production.If your baby suckles more,your breast will make more milk. If the baby stops suckling or if he never starts, the breast stops making milk. If you have twins and they both suckle, then your breasts will make extra milk for two babies. This is called the law of demand and supply.Feeding during night increases the supply of milk as more prolactin is secreted at night.

Ejection and flow of milk to your baby is due to production of another hormone called oxytocin. Stimulation of sensory nerves in the nipple by suckling also induces the production of `oxytocin' ( Fig. 5), which acts on the muscle cells around the alveoli causing the ejection and flow of breastmilk to your baby's mouth.These events are the milk flow response, or oxytocin reflex.

Oxytocin is produced quickly with the start of the suckling and is responsible for milk transfer from breast to the baby. If oxytocin is not produced adequately, the baby may

have difficulty in getting the milk. It may seem that breast is not producing milk, but the fact is the milk is there but not flowing.

Oxytocin release is affected by your mental state. Good feelings, thinking lovingly of your baby, feeling confident that your milk is the best and enough for the baby will stimulate oxytocin reflex. The sight of your baby and the sounds made by the baby also help increase the oxytocin reflex. If you lack confidence or doubt your ability to produce enough amount of milk for your baby it leads to decrease in oxytocin, and sets out a cycle of poor confidence, less secretion of oxytocin and you feel that the baby is not getting enough. Negative feelings like pain, worries, anxiety also inhibit the oxytocin reflex. (Fig. 6)

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