Lactogenesis and Composition of Breast Milk I. General Information A. Embryologically: belong to integument B. Functionally: part of reproductive system C. Modified apocrine sweat glands II. Anatomy Position and Attachment 1. 2. 3. 4. 5. Lateral aspect of pectoral region Located between ribs 3 and 6/7 Extend form sternum to axilla Surrounded by superficial fascia Rest on deep fascia Breast Anatomy Structure, continued … Secretory epithelium a. Changes with hormonal signals b. Onset of menstruation c. Pregnancy (glands begin to enlarge at 2nd month) Structure, continued … Vessels & Nerves 1. Arteries: derived from thoracic branches a. Axillary arteries b. Internal mammary arteries c. Intercostal arteries Vessels & Nerves, continued … Veins a. form a ring around the base of the nipple (“circulus venosus”) b. External mammary v to axillary v c. Internal mammary v to subclavian v Breast Anatomy, con’t… Nerve Innervation: derived from: a. anterior & lateral cutaneous nerves of thorax b. spinal segments T3 – T6 Lymphatics Subclavian nodes Axillary nodes Lateral pectoral nodes Parasternal nodes Lactation: four stages • Mammogenesis • Lactogenesis • Galactokinesis • Galactopoiesis Mammogenesis From 24th week of pregnancy Growth of ducts and lobuloalveolar systems Hormonal influencesestrogen, adrenal steroids, progesterone, estrogen, prolactin, adrenal steroids and growth hormone Lactogenesis I Begins during pregnancy Alveoli distend with colostrum Lactogenesis II Initiation of significant milk secretion at or just after parturition- colostrum Mature milk secretion begins 30-40 hours postpartum and averages 1-2 ml/g of breast tissue /day Lactogenesis III Milk supply is more firmly establishedautocrine control system begins More the milk is removed from the breasts, more the breast will produce milk Galactokinesis Ejection of Milk Suction exerted by the baby during suckling Contractile mechanism Draught sensation Lactation Reflex Galactopoiesis Maintenance Of Lactation Prolactin Sucking Composition of Breast Milk (gms/100ml) Sugar : 7 Fat : 3.5 Protein : 1.2 Minerals : 0.4 Water Calories : 67 : 89 ‘Breast fed infants, are Healthy Infants’ THANK YOU