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When the infant suckles, sensory nerve fibers in the areola trigger a neuroendocrine reflex that results in milk secretion from lactocytes into the alveoli. The posterior pituitary releases oxytocin, which stimulates myoepithelial cells to squeeze milk from the alveoli so it can drain into the lactiferous ducts, collect in the lactiferous sinuses, and discharge through the nipple pores. It takes less than 1 minute from the time when an infant begins suckling (the latent period) until milk is secreted (the let-down). [link] summarizes the positive feedback loop of the let-down reflex    .

Let-down reflex

This figure shows the process of let down reflex, the process in which the brain receives sensory impulses to release the hormones necessary for producing and discharging milk to the suckling newborn.
A positive feedback loop ensures continued milk production as long as the infant continues to breastfeed.

The prolactin-mediated synthesis of milk changes with time. Frequent milk removal by breastfeeding (or pumping) will maintain high circulating prolactin levels for several months. However, even with continued breastfeeding, baseline prolactin will decrease over time to its pre-pregnancy level. In addition to prolactin and oxytocin, growth hormone, cortisol, parathyroid hormone, and insulin contribute to lactation, in part by facilitating the transport of maternal amino acids, fatty acids, glucose, and calcium to breast milk.

Changes in the composition of breast milk

In the final weeks of pregnancy, the alveoli swell with colostrum    , a thick, yellowish substance that is high in protein but contains less fat and glucose than mature breast milk ( [link] ). Before childbirth, some women experience leakage of colostrum from the nipples. In contrast, mature breast milk does not leak during pregnancy and is not secreted until several days after childbirth.

*Cow’s milk should never be given to an infant. Its composition is not suitable and its proteins are difficult for the infant to digest.
Compositions of Human Colostrum, Mature Breast Milk, and Cow’s Milk (g/L)
Human colostrum Human breast milk Cow’s milk*
Total protein 23 11 31
Immunoglobulins 19 0.1 1
Fat 30 45 38
Lactose 57 71 47
Calcium 0.5 0.3 1.4
Phosphorus 0.16 0.14 0.90
Sodium 0.50 0.15 0.41

Colostrum is secreted during the first 48–72 hours postpartum. Only a small volume of colostrum is produced—approximately 3 ounces in a 24-hour period—but it is sufficient for the newborn in the first few days of life. Colostrum is rich with immunoglobulins, which confer gastrointestinal, and also likely systemic, immunity as the newborn adjusts to a nonsterile environment.

After about the third postpartum day, the mother secretes transitional milk that represents an intermediate between mature milk and colostrum. This is followed by mature milk from approximately postpartum day 10 (see [link] ). As you can see in the accompanying table, cow’s milk is not a substitute for breast milk. It contains less lactose, less fat, and more protein and minerals. Moreover, the proteins in cow’s milk are difficult for an infant’s immature digestive system to metabolize and absorb.

The first few weeks of breastfeeding may involve leakage, soreness, and periods of milk engorgement as the relationship between milk supply and infant demand becomes established. Once this period is complete, the mother will produce approximately 1.5 liters of milk per day for a single infant, and more if she has twins or triplets. As the infant goes through growth spurts, the milk supply constantly adjusts to accommodate changes in demand. A woman can continue to lactate for years, but once breastfeeding is stopped for approximately 1 week, any remaining milk will be reabsorbed; in most cases, no more will be produced, even if suckling or pumping is resumed.

Mature milk changes from the beginning to the end of a feeding. The early milk, called foremilk    , is watery, translucent, and rich in lactose and protein. Its purpose is to quench the infant’s thirst. Hindmilk is delivered toward the end of a feeding. It is opaque, creamy, and rich in fat, and serves to satisfy the infant’s appetite.

During the first days of a newborn’s life, it is important for meconium to be cleared from the intestines and for bilirubin to be kept low in the circulation. Recall that bilirubin, a product of erythrocyte breakdown, is processed by the liver and secreted in bile. It enters the gastrointestinal tract and exits the body in the stool. Breast milk has laxative properties that help expel meconium from the intestines and clear bilirubin through the excretion of bile. A high concentration of bilirubin in the blood causes jaundice. Some degree of jaundice is normal in newborns, but a high level of bilirubin—which is neurotoxic—can cause brain damage. Newborns, who do not yet have a fully functional blood–brain barrier, are highly vulnerable to the bilirubin circulating in the blood. Indeed, hyperbilirubinemia, a high level of circulating bilirubin, is the most common condition requiring medical attention in newborns. Newborns with hyperbilirubinemia are treated with phototherapy because UV light helps to break down the bilirubin quickly.

Chapter review

The lactating mother supplies all the hydration and nutrients that a growing infant needs for the first 4–6 months of life. During pregnancy, the body prepares for lactation by stimulating the growth and development of branching lactiferous ducts and alveoli lined with milk-secreting lactocytes, and by creating colostrum. These functions are attributable to the actions of several hormones, including prolactin. Following childbirth, suckling triggers oxytocin release, which stimulates myoepithelial cells to squeeze milk from alveoli. Breast milk then drains toward the nipple pores to be consumed by the infant. Colostrum, the milk produced in the first postpartum days, provides immunoglobulins that increase the newborn’s immune defenses. Colostrum, transitional milk, and mature breast milk are ideally suited to each stage of the newborn’s development, and breastfeeding helps the newborn’s digestive system expel meconium and clear bilirubin. Mature milk changes from the beginning to the end of a feeding. Foremilk quenches the infant’s thirst, whereas hindmilk satisfies the infant’s appetite.

Questions & Answers

Card 5 / 12: For whom would an appreciation of the structural characteristics of the human heart come more easily: an alien who lands on Earth, abducts a human, and dissects his heart, or an anatomy and physiology student performing a dissection of the heart on her very first day of class? Why?
Gelowe Reply
what are regular shaped cells with granules in the cytoplasam
Kabita Reply
PMNL
Dinu
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Omary Reply
cholesterol normal value is
BISWANATH Reply
less than 200mg/dl
Ashis
100 to159mg/dL
Dinu
Early this wk. I had some "A & P" questions & answers unfortunately didn't save them, Is there any way I can have them back ,so as 2 save them?. Thnx.
Kechi
what are the functions of the female reproductive system
Lister Reply
it produces the female egg necessary for reproduction, called the Ova or Oocytes. The system is designed to transport the Ova to the site of fertilization.
Kechi
Female reproductive system was mainly functioned to produce ova(ovum) (female eggs) Into which will be fertilized by male gamete to produce zygote
Omary
absolutely right
nimco
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Khaliil
waxwalba ka fikirbay ubaahantahay
Ahmed
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Khaliil
ha wayo jawabtoda wa qabyo nimco wey ku raacday
Khaliil
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Ahmed
asc if I try female reproductive system has two function the first is to produce egg cell and the second is to protact and nourish the offspring until birth
Muriidi
what is stercobilinogen
Hancerich Reply
fecal urobilinogen. Created by bacteria in the gut. a chemical that gives feces brown color.
Blayne
next question pls.
Kechi
The rate of diffusion increases if the
stella
What's the answer?
Kechi
it's a breaking down of haemoglobin and it's a chemical made by bacteria
Dev
Thnx Dev Raj.
Kechi
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Dev
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Kechi
what is the greatest muscle of the body
Lungu Reply
gluteus maximus
ABDULLAH
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Kechi
Gluteus maximus
THE
Describe anatomy of cardiovascular system?
cardiovascular system is a group of organs coming together to perform the circulation of blood. The organs invoked are the heart and the blood vessels with blood being the tissue. The heart is a pump and it pumps oxygenated blood through the systemic circuit and deoxygenated blood through the pulmon
bernard
pulmonary circuit.
bernard
more A&P questions pls. Thnx.
Kechi
If an ANOVA yields a significant F value, you could rely on ________ to test significant differences between group means.
Dane Reply
what's ANOVA
Cassandra
analysis of variance
Blayne
plz what you mean with "ANOVA" first
Fatima
anova means analysis of variance, a statistical method in which the variation in a set of observations is divided into distinct components.
Blayne
M value ot test
ABDULLAH
What does it mean by M value ot test?
Orpha
formation of red blood cells
Biketi Reply
explain why... lower back pain in ovarian cancer
Srijoni Reply
we says that protoplasm is the living part of us How?
Muzamil Reply
is the leaving part of our cellular structure.
Eric
it is the leaving part of our blood cellular structure also
ABDULLAH
what is receptor?
Preity Reply
an organ or cell able to respond to light, heat, or other external stimulus and transmit a signal to a sensory nerve.
Jessi
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Sandra
yes
yahye
yes
Allan
hey what is the process after your food is swallowed? how long does it take to get to the stomache until it is released as waste?
Fednise Reply
that is such a broad question. as you begin to swallow its various doses down the alimentary canal that brings the food into your stomach.then depending on whether it's a protein carbohydrate fat that dictates what function takes place in your stomach. these are all steps of digestion.
Joseph
typo sorry it's peristalsis , wave-like projections that push food down your alimentary canal etc. digestion starts in your mouth ends in your large intestines (colon anus)
Joseph
some of the many processes of digestion include hydrolysis dehydration synthesis denaturation of proteins etc. you have to be more specific.
Joseph
there's many different contributing factors the how long it takes food to convert into waste. remember fats, triglycerides proteins and carbohydrates all breakdown two different monomers and structures. you should be looking up metabolic processes.
Joseph
depending how much fiber you have in your diet dictates how much water is brought to your intestines that has to do with excretion whether fiber is insoluble or soluble. this is an anatomy and physiology app. to simply say the stomach will empty its contents in 2 to 3 hours would do you a disservice
Joseph
can the study of anatomy relate to medical technologies
Lean Reply
yes
Khh
absolutely
Jessi
yes...
Sherif
how can I understand micro biology and anatomy better.
Cassandra
yes
Kevin
someone to help me understand glycogeneogenesis
abel
what are the major branches of the aorta?
Kevin
look youtube video
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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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