So you have decided to breastfeed. Great! There is mounting evidence of the benefits of breastfeeding. You have surrounded yourself with all the great books with the facts and tips on getting it done. Super! But the decision and understanding are only part of the picture when it comes to breastfeeding.
Persistence plays a key role in our production of milk and in our baby’s feeding. This is because our production of milk is based on a feedback loop. To more fully understand this feedback loop, and how persistence plays a role in successful breastfeeding, let’s start with a basic understanding of the structure of our breasts and how milk is made.
What the breast is made of? Take some liberty here and imagine you are in Napa valley, in the middle of a vineyard between two rows of ripe grape trees. You pull a perfect stem of grapes off the vine. As you follow the main stem down, it branches smaller and smaller and eventually leads to the grapes. Imagine now that you have pulled a number of stems of grapes off the main vine. Now, hold them together in one hand between your fingers with the grapes hanging down, each by the main stem.
The inside of our breasts can be thought of as having this same general structure. Here is the analogy: each grape is a pool of milk surrounded by milk making cells. The skin of each grape and the stems are like little ducts lined with skin and muscle like cells that push the milk up to larger and larger ducts or stems. Where all the main ducts come together is like the area of stems you are holding between your fingers. These main ducts come together at our nipples then lead out. This entire structure of “grapes” or milk glands and ducts is about the same size in all women. The difference in breast size is caused mainly by the difference in the amount of fat and connective tissue that surrounds the milk ducts and glands in various women. Muscle lies under our breasts and covers the rib cage. Viou la! A milk-making machine.
There is a wonderful short slide show on the mayo clinic website that I think illustrates breast anatomy very well.
Now that we have a picture in our minds of the structure of our breasts, let’s explore the function of milk making:
While pregnant, our breasts gear up to make milk. Early in pregnancy the hormones progesterone and chorionic gonadotropin help to stimulate the growth and development of milk glands in our breasts. Toward the end of pregnancy, our breast glands secrete colostrum – a liquid we secrete in the first 3 days after giving birth that is rich in nutrients and immune supporting substances. After delivery, the level of progesterone drops suddenly and allows for the breast to be fully sensitive to the effects of the milk making and secreting hormones respectfully, prolactin and oxytocin.
Prolactin and oxytocin are made in a gland in our brain called the pituitary. Prolactin stimulates the milk making and oxytocin stimulates the release of the milk by stimulating muscle like cells in the breast to contract and empty the milk stored in the breast. But, if the brain doesn’t get the right signals, it won’t continue to make the levels of prolactin and oxytocin necessary to maintain milk production and secretion. And this is why persistence is REALLY important: In order to continue to make and secrete milk – the breast needs to be emptied of milk regularly and the nipple needs to stimulate regularly. Otherwise the breast won’t send the appropriate signals to the brain.
If you think about this, it makes sense from a “save your energy” perspective. If the brain sees, “the milk isn’t being used…it must not be needed…let’s focus on other things…” it will stop programming our bodies for the feeding function.
The point of me explaining this is that knowing how milk production happens will allow you to make appropriate decisions for yourself when it comes to breastfeeding. Why? You will undoubtedly be given well-meaning advice that will be detrimental to successful breastfeeding because it will compromise the physical persistence needed to maintain the stimulus-response cycle of lactation and just as importantly, the mental persistence you need to get over the challenges that come with breastfeeding. Here is an example.
After having her first child, Amanda is excited to start breastfeeding her baby girl, Cory. She positions Cory appropriately and Cory sucks, seemingly well…. but after the first few days of life, still seems hungry after feeds. Even though breast milk may not come in until day 5 of Cory’s life, particularly since Cory is her first baby, and she is getting valuable colostrum by breastfeeding, some loved ones tell Amanda to give Cory some formula in an effort to satisfy Cory’s hunger. Unfortunately, this addition of formula to Cory’s diet, especially in the early weeks of life and breastfeeding, may cause Amanda to have a reduction in milk supply, even if Amanda continues to breastfeed. Because of the positive feedback loop of suckling stimulating hormone release, stimulating milk production, helping to fill Cory’s belly, if Cory doesn’t empty the breast of the milk that is there, Amanda’s brain won’t know that Cory needs more milk and won’t release the hormones to make it. This is how the vicious cycle of a lower and lower milk supply can happen. And when it does, we sometimes blame our low milk supplies on our own body’s inadequacies…. when it may well be a very normal and adequate response to a lack of enough stimulation.
Remember this story when you are in Amanda’s position. Persist in your efforts and you and your baby will be on your way to wonderful breastfeeding experience.
