The composition of a woman's breast milk - which vitamins and minerals are included. What affects the composition of breast milk

Many of us know that breastfeeding is both feeding, normal baby food, and a convenient way to love, nurture and care for a baby. Do you know how a nursing breast works, how milk appears in it? The baby sucked out all the milk, and the breasts filled up again. Why does the breast fill up again after being emptied? What did our ancestors think about this? What do we know today? You will find answers to all these questions in this article. When you learn how the breasts of a breastfeeding mother work, you will appreciate even more the amazing process of breastfeeding, breastfeeding and breastfeeding mothers who nourish a new life outside the womb.

From the history
For thousands of years people have been interested in the anatomy and physiology of the breast. Earliest medical documents about the female breast go back to ancient Egypt. They describe how to tell if a mother's milk is good or bad and how to increase it. The author recommends rubbing cod-liver oil on the mother's back and having her "sit cross-legged ... rubbing her breasts with the poppy plant" to increase milk flow (Fildes 1985). Marilyn Yalom, author of A History of the Breast, explains: “At a minimum, both methods helped the mother to relax,” which in turn contributed to the flow of milk (milk ejection reflex), but most likely they did not affect its production. The ancient physician Hippocrates (460-377 BC) believed that menstrual blood was somehow converted into milk. This point of view dominated right up to the 17th century! During the Renaissance, Leonardo da Vinci (1452-1519) drew veins connecting the uterus and breasts in his anatomical drawings.
Even the philosopher Aristotle (384-322 BC) wrote about breastfeeding. He believed that women with dark color skin milk is healthier than that of whites, and that children who drank warmer mother's milk erupted teeth earlier. (He was wrong on both counts.) Aristotle also believed that children should not be given colostrum to drink. This misconception still persists in some cultures. Soran, an ancient gynecologist (practiced 100-140), advised breast massage and forced vomiting as a means to increase milk supply. However, he advised against drinking "drinks laced with the ashes of burned owls and bats" (Soranus 1991). By the 16th century, discoveries about the anatomy of the breast began to move in the direction of today's ideas. Studies conducted by pathologists have shown that the breast consists of glandular tissue, which, as the scientists of the time concluded, “transforms the blood going to the chest through the veins into milk” (Vesalius 1969).
Many early documents on breastfeeding dealt with the topic of wet nurses: women who were hired to breastfeed someone else's baby. Nurses are mentioned in the code of laws of Hammurabi (1700 BC), the Bible, the Koran and the works of Homer. There were clear guidelines for what qualities the best wet nurses should have, from hair color, shape and appearance of the breasts to the sex of the nurse's children (Yalom 1997). Beginning in the 18th century, physicians finally began to understand that it was better for a mother's health to feed her child herself rather than relying on the services of a wet nurse, and that mother's colostrum is good for the child (Riordan 2005).

Over the past 50 years medical science much more has become known about human milk, especially in the field of immunology. Today it is known that colostrum contains a huge concentration of antibodies that protect the newborn from diseases; that the composition and proportions of nutrients in milk are the standard of nutrition for infants and children. If a woman gave birth prematurely, her milk is different in composition from the milk of a woman who gave birth at term. The milk of a mother of a premature baby is adapted to the needs of such a vulnerable baby. The book "The Women's Art of Breastfeeding" says: "No two mothers with the same milk ... The composition of women's milk varies from day to day and differs even depending on the time of day ... The colostrum that the baby sucks on the first day of life is different from the colostrum on the second or third day.
Human milk is a complex living substance that lays the foundation for the health and optimal development of young children.

breast development
The breast begins to develop in the womb in both male and female fetuses. Between 4 and 7 weeks of embryonic life, the outer skin begins to thicken along a line from the armpit to the groin. This is how milk folds or milk lines are formed. Later most of of these "milk lines" disappears, but a small part in the chest area remains, and from 16 to 24 rudiments of the mammary gland are formed here, which develop and turn into milk ducts and alveoli - sacs in which milk is formed and stored.
At first, the milk ducts lead to a small depression under the skin, but shortly after birth, a nipple forms at this site (Sadler 2000). The nipple is surrounded by an areola. After this, the development of the mammary gland stops until puberty.
The next stage of breast development occurs when girls begin puberty, at about 10 to 12 years of age. The breasts begin to grow a year or two before the onset of menstruation. Breast tissues grow little by little during each ovulatory cycle. The main growth of the breast occurs during puberty, but continues until about 35 years of age (Riordan 2005). The breast is not considered fully mature until the woman has given birth and is producing milk (Love & Lindsey 1995).
In "Breastfeeding. Questions and answers." (The BREASTFEEDING ANSWER BOOK) it is written that a mature breast consists of glandular tissue for the production and movement of milk; supporting connective tissue; blood, which delivers the nutrients necessary for milk production; lymph - a fluid that removes by-products through the body's lymphatic system; nerves that send signals to the brain; and adipose tissue, which protects against damage (Mohrbacher & Stock 2003). The glandular tissue consists of alveoli, which produce and store milk until the surrounding muscle cells push the milk into the small (alveolar) ducts. The small ducts further merge into larger ducts that open at 5 to 10 lactiferous pores at the tip of the nipple. Until recently, it was believed that in addition to the alveoli, milk is also stored in the lactiferous sinuses, extensions of the ducts just before the nipple. However, recent ultrasound examinations showed that the lactiferous sinuses are not permanent breast structures (Kent 2002). The milk ducts under the nipple dilate under the influence of the milk ejection reflex, but narrow again after the end of feeding, when the remaining milk returns back to the alveoli.
The structure of the chest can be compared to a tree. Alveoli are leaves, ducts are branches. Many small branches merge and form several large branches, which in turn form the trunk. Like the branches of a tree, the breast consists of lobules, each of which is formed from one large duct with many small ducts and alveoli connected to them. Most experts believe that women have between 15 and 20 such lobes in each breast, but one recent study states that there are more likely 7-10 in each breast (Kent 2002).
The areola or areola, the dark area around the nipple, gets its color from the pigments eumelanin and pheomelanin. The areola contains sebaceous glands (which secrete oil that softens and protects the skin), sweat glands, and Montgomery's glands, which secrete a substance that lubricates the nipple and protects it from bacteria.

Pregnancy and lactation
During pregnancy, the breast changes a lot under the influence of pregnancy hormones, which include estrogen, progesterone, prolactin. Each hormone plays a specific role in preparing the body for breastfeeding. The most noticeable change is breast enlargement. During the first trimester of pregnancy, the ducts and alveoli grow and branch at a high rate. Many women report that their breasts have become more sensitive.
Lactogenesis is a term to describe the onset of lactation. There are three stages of lactogenesis. The first stage begins approximately 12 weeks before delivery, when the mammary glands begin to produce colostrum. The breasts enlarge even more as the alveoli fill with colostrum, but due to the mother's high levels of progesterone, milk is not fully produced until the baby is born.
The second stage of lactogenesis begins after birth or separation of the placenta. Progesterone levels fall while prolactin levels remain high. Prolactin is the main hormone of lactation. It is produced under the influence of pituitary, thyroid, adrenal, ovarian and pancreatic hormones. More oxygen-rich blood rushes to the chest. Milk comes in 2-3 days after birth. The amount of milk increases rapidly, the composition of milk changes: colostrum is gradually replaced by "mature" milk. The amount of sodium, chlorine and protein in milk decreases, while the amount of lactose and other nutrients increases. The color changes from golden yellow, the typical color of colostrum, to a bluish white. Because this stage of lactogenesis is driven by hormones, milk is produced in the breast whether the mother is breastfeeding or not. During this time it is very important to feed frequently (and/or pump if the baby is not breastfeeding or suckling well) as frequent feedings in the first week postpartum are thought to increase the number of prolactin receptors in the breast. Receptors recognize a certain hormone and respond to it. The more prolactin receptors, the more sensitive the mammary glands to prolactin, which, according to researchers, affects the amount of milk a mother has. next stage lactogenesis.
The third stage of lactogenesis is also known as milk production. At this stage, the production of mature milk is established. Now milk is produced not under the influence of hormones (endocrine control), but under autocrine control. This means that further milk production depends more on how much the breast is emptied, and not on the level of hormones in the blood. Milk is produced according to the principle “demand creates supply”, namely, the more the mother breastfeeds, i.e. The more the baby suckles, the more milk will be produced. And accordingly, the less to feed, the less milk will be.

Physiology and amount of milk
Understanding the process of milk production can help a mother organize breastfeeding so that her baby always has enough milk. For example, sometimes a woman feels that the baby has completely emptied her breast, and there is nothing left in her at all, although the baby has not yet eaten. If a mother knows that milk is constantly produced in the alveoli, she will confidently breastfeed her baby, even if it seems “empty”. One study found that babies, on average, suck out only 76% of their milk per day, which is this moment is in the chest.
Milk production depends on how the breast is emptied. When a baby suckles, a signal is sent to the mother's brain that triggers the release of the hormone oxytocin. The release of oxytocin into the blood leads to contraction of the muscle cells around the alveoli, causing milk to be pushed through the ducts to the nipple. This is the milk ejection reflex. At this point, a woman may feel a tingling sensation in her chest or feel her milk rushing in, which is why this reflex is called a flush. During the tide, the alveoli are emptied, and milk flows to the nipple, from where it is sucked out by the baby. When the alveoli are empty, they produce more milk. Recent studies have shown that human milk contains organic compound called "feedback lactation inhibitor", which regulates milk production. When there is a lot of milk in the breast, this protein signals the alveoli to stop producing milk. After the baby has emptied the breast, and therefore there is no longer a "lactation inhibitor" that stops milk production, the alveoli begin to produce milk again. That is why it is so important for the optimal amount of milk to put the baby to the breast often and let him empty the breast as much as possible.
Another factor that affects the amount of milk is the storage capacity of the breast. Sometimes women with small breasts worry that they will not have enough milk. These experiences are in vain: the amount of milk does not depend on the size of the breast. A small breast may not store as much milk between feeds as a large one, but if you frequently breastfeed your baby, the milk will be just the amount your baby needs. Women with larger breasts and greater breast storage capacity can afford to breastfeed less often, and this may not affect milk supply. On the other hand, some women with small breasts need to feed more frequently as their breasts fill faster and milk production slows down as the alveoli fill up. Frequent breastfeeding not only has a positive effect on milk supply, it is also a good prevention of congestion and breast infections. per day” [regardless of breast size]).
Does a mother need to know how much milk her breasts can hold per feeding to determine how often she should feed her baby? Definitely not. Healthy babies suck out exactly as much milk as they need and when they need it, while mothers do not even have to rack their brains about what is happening in the breast. The idea of ​​how a nursing breast works can only be useful in cases where a woman needs to figure out why she does not have enough milk. In addition, this knowledge will help a woman to analyze the myths and misconceptions about breastfeeding. For example, she will know that she doesn't have to wait between feedings for her breasts to "full" - there is always milk in her breasts. theory will become good help and in cases where the child seems hungry, or he has a growth spurt: a woman will confidently feed once again, because. knows that more frequent feedings will speed up milk production almost immediately.

How do substances get into breast milk?
Understanding how milk is produced helps a mother understand how various substances (proteins, as well as harmful substances or drugs) pass into milk. This will help a woman decide how to eat, get treated, what lifestyle to lead when she is breastfeeding.
How do different substances get into milk? When a woman takes medicine or eats food, they are broken down in the gastrointestinal tract (GIT), and then the molecules of these substances are absorbed into the blood. Together with the blood, the molecules enter the capillaries breast tissue where they enter the milk through the cells lining the alveoli. This process is called diffusion.
This is how different components of milk, as well as drugs and other substances, enter the milk. However, whether a particular substance gets into milk, and in what quantity, depends on many factors. In the first days after childbirth, there are gaps between lactocytes, cells that line the alveoli and block or let in various substances. Therefore, in the first days after childbirth, substances can penetrate the milk more freely. After a few days, the lactocyte gaps close. From this point on, it is more difficult for various substances to penetrate the barrier between blood and milk (hematomilk barrier).

Thanks to the diffusion process, various useful components, such as antibodies, enter the colostrum and mature milk. Antibodies are protein molecules that make up the blood and help the body fight infection. In human milk, the highest concentration of antibodies occurs at the beginning and at the end of lactation. Very important antibodies - secretory immunoglobulins A (SIgA) - are synthesized and stored in the breast. In addition to SIgA, there are about 50 antibacterial factors in milk, many of which get there from maternal blood. And this does not include those factors that have not yet been discovered! Antibodies and antibacterial factors are one of the most important benefits of breastfeeding. All women pass on antibodies to their babies during pregnancy and childbirth, but breastfeeding helps the mother protect her baby from disease even longer.
As a result of diffusion, substances that may disturb the baby also enter breast milk. Many people think that if mom eats gas-producing food, such as cabbage ( different types), the baby will also puff. Is it true? No. The gases themselves do not penetrate into the blood from the gastrointestinal tract, and therefore do not enter the milk. However, in the process of digestion of food, some proteins from food enter the bloodstream and then into milk. Some babies react to certain types of protein: their tummy swells, they worry. If the mother notices that after eating a certain food, the baby has such a reaction, you can try to temporarily exclude this particular product from the diet. It is especially important to note here that in most children, the cause of anxiety and gas formation lies in something else. allergic reactions for individual substances in breast milk manifest as skin irritations, respiratory problems and gastrointestinal problems. If someone in the family is allergic to certain foods, the mother should refrain from them for the period of breastfeeding.
What does all this mean for breastfeeding moms? A nursing mother can eat whatever she wants and can be sure that most children do not react in any way to what they eat from their mother.

Medicines taken by a breastfeeding mother can also cross the lactocyte barrier from the blood into the alveoli. Thomas Hale, author of Drugs and Mother's Milk, writes that there are several factors that affect medicines into milk. The concentration of the drug in the mother's blood affects the amount of the drug that passes into the milk. If there is a high concentration of the drug in the blood, it will enter the milk, where its concentration is lower, in the process of diffusion. more medicine. During diffusion, the concentration of substances is maintained at the same level on both sides of the barrier. Therefore, as the concentration of a certain substance in the mother's blood decreases, particles of the same substance that have entered the milk will return to the blood, and its concentration in the milk will also decrease. (Author's note: How to find out when there is the most of some substance in milk? This can be determined if you know the time maximum concentration(Tmax) drugs in the blood. Usually this information is in any pharmacological reference book. In practical terms, this means that feedings can be scheduled so as not to feed at the time when blood drug concentrations are highest.)
Why is it important to understand the diffusion process? Some moms mistakenly think that after they drink a glass of wine, the alcohol will be in their milk until they express it. As a result, she hesitates whether to feed the baby or express and pour out the milk. In fact, the level of alcohol in milk will decrease at the same time as in the blood. In a woman weighing 54 kilograms, the amount of alcohol contained in one glass of wine or beer will disappear from the blood within 2-3 hours. After the same time, no alcohol will remain in the milk. (Author's note: You can determine when the concentration of a substance in milk decreases by looking at the pharmacological reference book. The half-life (T 1/2) indicates the period of time during which the concentration of the drug in the body decreases by 50%).
The extent to which a drug enters the mother's milk is also affected by the molecular weight (actually the size of the molecule) of the substance that makes up the drug, protein binding, and fat solubility. Substances with a low molecular weight penetrate milk more easily. (Author's note: Substances with a molecular weight of less than 200 easily pass into milk. If most of the drug binds to proteins, the drug cannot pass into milk, because the drug is "glued" to the protein, and there are no free drug molecules in the plasma, which could easily pass into milk if they were not associated with proteins.Milk contains more fat than plasma, so fat-soluble drugs can concentrate in milk fat.In Drugs and Mother's Milk, T. Hale writes, that many drugs are compatible with breastfeeding.If a drug is incompatible with breastfeeding, it is almost always possible to find a suitable replacement for it.If a woman needs to take medication, she should consult a doctor.Modern medicine has huge amount knowledge about physiological process lactation than ever before in history. We have data on the structure of the breast, information on how the constituent parts of the breast work to produce milk. Compared to the past, we have a good idea of ​​how different substances get into breast milk. Armed with knowledge, we can successfully manage breastfeeding, avoid unnecessary weaning, and address any problems that may arise during breastfeeding. This makes us appreciate the opportunity to breastfeed more when everything is going well!

Motherhood, from the point of view of psychological readiness, is laid from the very moment when the girl begins to realize her feminine principle. From that moment on, she begins to show interest in the relationship between mother and child. This interest is often manifested unconsciously, through the game, for example, in daughter-mothers. Thus, the girl experiences the model that is forming in her mind. family relations, gets acquainted with his future role as a mother. Therefore, it is more correct to speak of motherhood as well as a skill, and not just as an instinct inherent in nature.

As a girl prepares for motherhood throughout her conscious life, the body of a future mother learns to produce milk for a baby according to an individual recipe during the entire period of pregnancy. With special trepidation, the future young mother awaits the moment of pregnancy, when colostrum appears. The secretion of this unique liquid from the breast during pregnancy signals the preparation of the mother's body for breastfeeding. What is colostrum and why is mother's milk so necessary for a newborn?

Colostrum is a thick, high-calorie, sticky liquid of a white, orange or yellow hue that begins to be produced in the body from the first weeks of pregnancy. An inexperienced mother who does not know what color colostrum should be, such unusual tones can alert. However, this phenomenon is quite natural. Warm shades are given to this nutrient liquid by carotene, a pigment that is a precursor of vitamin A and is found in large quantities in.

Primary mother's milk has salty taste. This is due to the significant content of sodium chloride. Salted colostrum is well absorbed, as the qualitative composition of proteins and salts is close to blood serum.

Colostrum is excreted in rather small portions. The volume of the first doses of colostrum is only 10-40 ml, but due to its nutritional value and value, it fully satisfies the needs of the baby. This small amount of food is also associated with the very small size of the stomach of newborn children.

Colostrum, being the forerunner of transitional and mature milk, also differs in terms of its composition. Colostrum and mature breast milk are often referred to as "white gold" or "elixir of life". The healing liquid is endowed with these epithets for its amazing properties.

• Colostrum is very high in calories, but at the same time it does not pose a serious burden on the organs of the gastrointestinal tract and liver.
• "Elixir of Life" is rich in immunoglobulins, macrophages, leukocytes that protect the intestines and the entire body of the baby from the effects of infections. The highest concentration of these protective substances is observed in the first hours of lactation. It is these substances that provide the strongest immune defense of the body and create favorable conditions for full development.
• Colostrum contains more protein, carotene, vitamins A, B12, E, K, mineral salts than in mature milk. The share of fats and milk sugar, on the contrary, is somewhat lower.
• The growth factors contained in the healing maternal fluid prevent the appearance of allergies in the baby.
• Colostrum has a laxative effect, which is very important when removing the original stool (meconium). This factor reduces the likelihood of developing physiological jaundice in children who are breastfed.

It is with these features that the huge benefits of breastfeeding a newborn are associated.

When does colostrum begin to be secreted?

Notice the secretion of colostrum in the mammary glands future mom maybe as early as 13 weeks pregnant. Bright droplets of the substance can appear on a woman's nipples after taking a shower, during intense physical activity, or on hot summer days. At the same time, most often the appearance of colostrum on the nipples or underwear, the expectant mother notices in the third trimester, when the liquid begins to be released most intensively.

For some women, colostrum does not appear on the surface of the breast during the entire period of pregnancy. This is due only to the characteristics of the glandular tissue of the breast. Most likely, the fluid is enough space for the lobes and ramifications of the ducts in the mammary glands.

It should be noted that the process of excretion of colostrum during pregnancy is not a factor confirming the appearance of the required volume of milk at the birth of a child. Just like the lack of milk during pregnancy does not mean that a woman will not be able to breastfeed her baby.

transitional milk

From 4-5 days after delivery, transitional milk begins to be produced in the female breast. This substance, no less useful than colostrum, is rich in fats and, in its composition and appearance, approaches mature milk.

• Transitional milk changes its color to white or light blue. The concentration of sodium, carotene, vitamins and other useful substances in this liquid is gradually decreasing, but at the same time the proportion of carbohydrates and B vitamins increases. The volume of milk in a nursing mother also increases markedly.
• Salted colostrum is gradually replaced by lactose-rich sweet transitional milk. Lactose is involved in the development of the baby's nervous system, functions as the main energy component. This disaccharide affects the formation of beneficial intestinal microflora.
• Transitional milk contains the most important complex of components that protect the child's body from tumor cells, causing their self-destruction. The scientists called these unique compounds the HAMLET complex, which is widely studied for the manufacture of anticancer drugs.

Transitional mother's milk will be produced until the baby reaches two weeks of age. Then it will be replaced by mature milk, which the baby will eat until the end of the breastfeeding period.

mature milk

After how much mature milk should come and when should colostrum appear? After 2-3 weeks after birth, transitional milk is replaced by mature milk. It is worth noting that the composition of all described breastfeeding products has not been fully studied. To date, approximately 500 useful components have been identified that contain mother's milk.

How useful is breast milk for a child and what is the secret of its uniqueness? Directly in the unique composition lies an amazing phenomenon and the amazing value of female breast milk.

• The milk of a nursing woman contains a significant amount of water (up to 87%). This property allows you to refute the fact that the baby definitely needs to be supplemented. In addition, breast milk is significantly superior in useful properties to the best quality water. Mother's milk is a biologically active liquid, enriched with salts, vitamins and many other elements necessary for the child.
• Mature milk is rich in carbohydrates, including lactose. This disaccharide improves the absorption of calcium and iron, saturates the brain and promotes the development of the baby's nervous system. Human milk contains much more milk sugar than other mammals. For example, female dolphins, one of the most “intelligent” animals, rank second in lactose content in milk.
• Mature milk, like colostrum, is rich in proteins. Their special value for the child is due to the fact that each of these unique proteins is specially produced by the mother's body based on the specific needs of her child.
• The benefit of breast milk also lies in the fact that it is easily digested and absorbed by the baby's digestive system. This feature is associated with the content in the "miraculous elixir" of special enzymes that speed up the digestion process.
• The properties of breast milk and its vitamin composition are associated with the nutrition of the mother. But, this does not mean that if the mother's diet is not varied, then the baby will not receive any components. Certain supply of nutrients female body produces already at the stage of pregnancy. Therefore, often with a deficiency of certain substances, the mother's body uses these reserves. Therefore, mature milk is always balanced and contains the necessary composition.
• The temperature of breast milk is optimal for feeding and maintaining the integrity of all components, which are the benefits of breast milk.
• Mom's milk is also a source of beneficial bacteria, which are so necessary for the intestines of a newborn. The flora of the baby contains up to 99% of the necessary probiotics, which play a huge role in the formation immune system crumbs.
• Surprising is the fact that with an infectious disease of a nursing mother, her milk changes its composition, being enriched with antibodies that will help the baby not become infected with the disease or it is easier to endure it. Thus, breastfeeding is also an amazing unique protection for the baby.
• The benefits of breast milk after a year do not decrease, despite numerous misconceptions. During this period, its function gradually changes. By the age of one, the baby is introduced to many foods, from which the baby receives the necessary nutrients. Therefore, the role of milk as a nutrient gradually decreases, although the concentration of fats in it increases. At the same time, the importance of milk as a natural antioxidant is preserved.

This list contains only a small fraction of the healing properties of the miraculous mother elixir. That is why breast milk is so important for a newborn. These factors cannot reflect the full benefits of breastfeeding, since many of its phenomena are not fully understood. Every year, scientists discover more and more beneficial compounds in human milk.

About composition variability

Milk in lactating women has an amazing ability to transform. Moreover, the composition of nutrients may vary depending on the needs of the baby. The color and content of colostrum changes throughout pregnancy and after childbirth, and how colostrum or mature breast milk looks like coming out of the breast depends on many factors, including the age of the baby. The composition of milk varies different time days, at the beginning and end of feeding. It will change its properties if the baby is born prematurely or gets sick, if the baby is frightened or has painful gums, and in many other situations when the baby's body needs support.

Fore and hind milk

Mature human milk is usually divided into early and late, it is also called foremilk and hindmilk. At the beginning of feeding, foremilk is released from the breast, at the end - hindmilk. The difference between these nutrient fluids is palpable not only visually. What is fore and hind milk is well known to a nursing woman who has resorted to decanting. Foremilk has a bluish tint, rich in water, lactose, mineral salts, vitamins. saturated hindmilk white color contains a large amount of fat. The density of the anterior breast milk is higher due to the lactose, minerals it contains. Therefore, hindmilk accumulates on the surface during pumping, forming a less dense and light component. In the container, these substances will differ significantly, a kind of line will form between them. In order for the baby to develop properly, when feeding, the baby must completely empty the mother's breast in order to receive the most nutritious late milk as well.

Imbalance of foremilk and hindmilk

A lot of controversy among modern doctors is caused by such a thing as an imbalance of fore and hind milk. This condition can occur in women with hypergalactia, when the glands produce more milk than the baby needs. This is possible if the child, having badly sucked one breast, receives a second one. At the same time, at the stage of feeding, the child does not receive the full high-calorie hindmilk. In addition, the baby may develop, since lactose-saturated foremilk too quickly enters the baby's intestines without having time to interact with lactase enzymes. Not fully split lactose can cause loose foamy stools, increased gas formation, and low weight gain in infants.

How is breast milk renewed?

The amount of milk depends on efficient removal it from the mammary gland. It is updated constantly. The more actively the child suckles the breast, the more milk is produced and the sooner the gland is filled with a new portion of milk. The concentration of certain substances, including alcohol, antibiotics, allergens, also depends on their half-life, blood concentrations, and many other factors. The ability to be updated every minute is also due to the fact that the substances of the nutrient fluid are designed to satisfy the urgent needs of the baby. Therefore, breast milk is renewed continuously and most intensively immediately after feeding.

How to improve the quality of breast milk

Sometimes, observing a clear liquid secreted from the breast, a woman may mistakenly conclude that her breast milk is of poor quality. Many loving moms are trying to improve the quality of breast milk with the help of certain products and diets, supposedly improving the properties and fat content of milk. Scientists have proven that the composition of breast milk meets the needs of the child, even if the nursing mother does not receive certain nutrients. In this case, the stocks laid down during pregnancy are used, and malnutrition can lead to disturbances in the body of only the most nursing woman. Mom can only accept and correctly use the gift that the nature of her baby has bestowed.

To understand how to improve the quality of breast milk, you also need to know that many components of medicines, alcohol, nicatin enter the blood of a nursing woman, and, accordingly, into the baby's body when milk comes. Nicotine and alcohol cause toxic effects on the child. A young mother should avoid the use of excessive amounts of spices, extractives, garlic, horseradish, which can give her nutrient fluid an unpleasant taste.

Formulas for nursing mothers

Manufacturers of special powdered milk formulas for nursing mothers know how to improve the quality of breast milk. These supplements contain whole complexes of substances necessary for the development of the child. However, these funds are recommended rather for adjusting the nutrition of the woman herself and for replenishing her body with the necessary substances.

Some mixtures are indicated for women whose children are at risk of developing allergies. They use proteins plant origin("Amalthea", "Madonna"). A certain food group for nursing is aimed at enhancing lactation. Such mixtures and specialized teas contain lactogenic additives - nettle, anise, cumin ("Lactamil", "Milky Way").

Sometimes an inexperienced mother is worried about questions: “Can breast milk not be suitable for a child?” It is worth noting that this formulation may be relevant only in some cases with lactase deficiency in a baby or in the presence of serious illnesses at mother.

In custody

Thanks to this article, a young mother learned when colostrum should appear, why milk is prone to transformation, how quickly “white gold” changes, how breast milk is useful for a baby, how to improve its quality and what a woman should do if there is an imbalance in milk.

In conclusion, I would like to set up mommy for long-term breastfeeding. This process has been overgrown with myths and fears over the years. Therefore, it is very important to abandon the many outdated misconceptions. For the development of lactation, it is necessary to be convinced of the benefits of breastfeeding, to provide the baby with optimal nutrition. Perhaps the most important criterion is that none of the most advanced blends can replace even that close emotional connection and the feeling of happiness and peace that breastfeeding brings to mother and baby.

Mother's milk is indispensable for the baby as the main food from the first days of life. The natural mechanism inherent in a woman by nature is of incomparable value for the existence of mankind. However, more and more young women refuse it, preferring to feed their children artificially. What actually is lactation, how is it formed, what benefits does it give to mother and child?

Breastfeeding is an unforgettable experience in a woman's life, as well as establishing a close emotional connection with a newborn.

When and how does lactation occur?

Lactation is a difficult but natural moment for a woman to form breast milk, which accumulates in the breast and then is removed from it by the baby sucking on the nipple. The basis of what is happening is hormonal restructuring, which does not depend on the size of the bust. The preparation of the mammary gland for the production of milk in it is called lactogenesis. Lactopoiesis is the medical name for maintaining lactation.

The beginning of the development of lactation changes occurs during pregnancy, and at the time of childbirth, the already properly adjusted hormonal background of a woman causes the arrival of milk. Where does breast milk come from?

The required amount of milk is formed due to the presence in the mother's body of three hormones: prolactin, placental lactogen and oxytocin. Entering the bloodstream, these hormones stimulate the onset of the lactation process in a woman who has given birth.

Let's see what they are responsible for, and how the physiology of the female body contributes to this.

Hormones and their features

We have already found that the natural physiology of lactation is determined by three important hormones. Each of these three hormones performs its own predetermined role. Placental lactogen is secreted by the cells of the placenta in late pregnancy, when the mechanism for preparing the breast for successful milk production is activated. The concentration of the hormone gradually decreases after childbirth, and after a few days it completely disappears from the blood of the fetus and mother.

Placental lactogen is produced at the stage of gestation

Prolactin initiates and maintains normal milk production during lactation. If the amount of prolactin in the blood does not correspond to the normal value, a failure occurs. The hormone belongs to the peptides, and it is produced in the pituitary gland. An increase in the amount of prolactin begins at the time of pregnancy, and by the time the baby is born, the cells that secrete it make up 70-80% of all pituitary cells. Prolactin is not without reason called the hormone of motherhood, because only thanks to it the whole mechanism of milk formation is triggered during breastfeeding.

Oxytocin organizes the movement of fluid through the milk ducts and supports the reflex process of milk release. You can feel how it works by feeling a slight tingle in the chest and when a small amount of milk comes out between feedings. Nutrient fluid accumulates in the alveoli, then passes through the tubules and ducts, overcomes the sinuses and enters through the nipple to the baby.

Duration of lactation

Duration refers to individual indicators and can vary from several months to several years. The recognized norm is indicated by specialists within 5-24 months. The first weeks after the birth of the baby, the volume of nutrient fluid in the mother may vary. Its stable amount is established after 6-12 days, and milk is produced as much as is necessary for the full development of the child. From this point on, lactation lasts at least 3-6 months.

After a two-year milestone, lactation will be suspended naturally

The synthesis of hormones that support the formation of milk is completed if a woman stops breastfeeding, it takes about 1-2 weeks. An important component of everything that happens is the regular emptying of the mammary gland. If the regular emptying of the breast is not observed, the secret stagnates in the alveoli and ducts, the arrival of milk slows down and may stop altogether. In just a day, the mother produces 600-1300 ml of milk.

How many stages is lactogenesis divided into?

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Let's take a closer look at lactogenesis. Physicians, it is decomposed into several important stages:

• The 1st stage begins 12 weeks before the birth of the child, when colostrum is produced in the cells of the mammary gland. The level of prolactin, estrogen and progesterone rises, against this background the female breast changes, its sensitivity increases. Prolactin controls the development of the alveoli and lobules in the mammary gland.
• Stage 2 starts at the time of delivery. Doctors tend to determine its onset from the first attachment of the baby to the breast. The baby makes the first attempts at breastfeeding and receives the most valuable maternal colostrum.
• Stage 3 is a transitional stage, marked by the gradual transformation of colostrum into full-fledged milk. The duration of the third stage takes 3-7 days. It takes place in three steps: the first 3 days colostrum is produced, then early transitional milk is formed, which is replaced by late transitional milk, and finally, the production of mature milk begins.

The complete formula for lactogenesis looks like this: colostrum -> early transitional milk -> late transitional -> mature milk. If the transition from colostrum to the first two forms takes about 3-7 days, then it takes from 3 weeks to 3 months to reach milk maturity. Since hormones are involved in all stages of lactation, its course does not depend on whether the woman is feeding the child or not. For the proper production of breast milk, it is important to follow simple rules:

• Feed the baby often to increase the number of prolactin receptors in the breast. It contributes fast interaction components of the breast with prolactin, which ensures the production of milk. The compound that occurs prepares the ground for the next stage of lactogenesis.
• Refuse hourly regulation of feedings. The child should be breastfed on demand, at least every 2 hours, including at night. It is better not to express the breast and not to soothe the baby with a dummy or nipple.

Why does the breast hurt during lactation?

Where does chest pain come from? Pain in the breast appear at the second stage of lactation, when the hormone oxytocin comes into action. The “oxytocin reflex,” as doctors call it, is characterized by the following features:

• before and during feeding, it tingles and burns in the chest;
• felt pain syndrome and a feeling of excessive fullness in the chest;
• the breast begins to leak a few minutes before feeding;
• when an infant stops feeding, milk continues to flow.

At the second stage of the formation of lactation, the breast can noticeably hurt

The release of oxytocin from the cells starts at the moment the baby sucks the breast. The baby stimulates the nerve endings of the nipple, as a result of which hormone production begins in the posterior pituitary gland, which passes into the chest cavity through the blood. Accumulating during sucking, oxytocin provokes the release of milk during feeding. This is the oxytocin reflex. The hormone does not stimulate the release of milk if:

• feeling pain, the mother does not give the baby a breast;
• the parent is upset or very offended;
• feels anxious and restless;
• has doubts about his abilities.

Young women in labor should remember that sufficient breast filling is directly related to their emotional state, because it takes place under the control and with the participation of hormones. Obviously, the processes are closely related. If you are worried, tense because of any difficult family situation, you are afraid, then milk will not arrive normally.

If in the last trimester of pregnancy, the expectant mother was worried and worried a lot, there may be problems with lactation

How is milk production?

Milk formation occurs when the milk reaches a mature "age". If you are giving birth for the first time, then the transition from early and late to mature milk lasts from 1 to 3 months, for women in labor with experience, this process takes 3 weeks-1.5 months. The signs of milk maturity are:

• soft to the touch chest;
• there is no feeling of breast filling before feeding;
• painful hot flashes stop;
• milk production begins immediately at the time of feeding.

The difference between the preparation for the start and the actual milk formation is that milk does not come from an increase in the number of hormones oxytocin and prolactin, but as a reaction to the baby suckling. The volume of nutrient fluid depends on the degree of breast emptying. The “empty vessel” principle comes into play: feeding, empty breasts, milk production. The main thing is to adhere to the rules of frequent feeding both day and night.

After the establishment of mature lactation, milk begins to arrive immediately before feeding

Why do lactation crises occur?

A lactation crisis is a few short-term (2-7 days) segments in the life of a child, when he, unreasonably worried and irritated, requires constant attachment to the breast. The timing of their onset is individual and falls on the age of 3 weeks, six weeks, 3 and 6 months. The causes of lactation crises are:

• Growth activation. The child begins to grow, as they say, by leaps and bounds, he does not have enough food, so he grabs the breast to fill his needs and adjust the filling of the mammary glands to his increased appetite.
• The reaction of the mother's body to the full moon. The period when some parents decrease milk production, while others, on the contrary, increase.

How to correctly assess the situation?

Test wet diapers. If more than 12 pieces are recruited (girls have more than 10), the baby adds about 113 grams in weight (the minimum norm according to WHO) per week, which means that you have enough milk. However, you may get the impression that you are only feeding your child all the time. The baby, barely having time to empty one breast, grabs the other. Please note that such behavior of the baby is included in the concept of the norm and does not serve as an indicator of a lactation crisis. An increased desire to eat can be caused by improper care or a stressful situation for the baby.

The wet diaper test (or the number of urinations in the diaper) reveals whether the baby is getting enough milk

With a lactation crisis, the baby's anxiety increases, associated with a lack of the necessary volume of milk, which can provide all his nutritional needs. It would be a mistake to blame only the lactation crisis. The baby can be capricious and because of bad weather, because of sudden changes in atmospheric pressure. Affects the psycho-emotional background of the child and the full moon, and too noisy water procedures, and long walks, and the presence of strangers.

How to behave during this period?

It is possible that you will not face a crisis or it will pass unnoticed to you. Initially, you should not tune in to such a problem, all the more wrong to expect its onset. Remember the main principle of milk production - demand creates supply. This means that the more volume the baby sucks, the faster it is replenished. The child instinctively “hangs” on the chest in order to provide himself with the right amount in advance. Mom should not rush to supplement her treasure with mixtures. It is wrong and not to give the baby a breast on demand. Try not to worry, wait a bit, and you will see that within 3-7 days milk will begin to be produced as much as the little gourmet needs.

Do not worry about the lack of milk during the lactation crisis - the more often you put the baby to the breast, the more milk will appear

What is lactation involution?

The involution of lactation is its complete completion (see also:). Its first signs appear in 2-3 years. Natural involution should not be confused with forced weaning. The correct course of involution of lactation occurs at a natural level, when the body of the parent physiologically stops milk production. Artificial termination lactation period does not apply to the concept of involution. What is the involution of lactation and how does it go?

How does it affect the mammary glands?

Cardinal changes begin with a regression of the processes that occurred during the entire period of feeding. The natural closure of the excretory ducts on the nipples begins, the glandular tissues are replaced by fatty tissues, the breast takes its former shape and state in which it was before pregnancy. The breast becomes completely incapable of feeding on the 40th day, if you count from the last feeding. It is worth noting that the time duration of lactation involution is the same for all women and does not depend on how long your lactation period lasted.

In preparation for lactation and in the process of it, the breast undergoes changes

Signs of involution

Discomfort during breastfeeding, an acute desire to stop it - this does not mean that the time has come for the natural involution of lactation. To accurately establish the beginning of the involution of breastfeeding, there are certain signs. It is useful for nursing parents to know them, so we will dwell on them in more detail. Carefully read each sign so as not to be frightened and not to amuse yourself with vain hopes.

Child's age

Having breast-fed the child for up to a year, the mother begins to think about transferring him completely to normal nutrition. Desire comes from different reasons: to be course treatment, going to work, advice from relatives and friends. The justifications that have been found lead to the false idea that completion occurs naturally. Passing off wishful thinking, you forget about the precisely set deadlines for involution - the age of the child is 2-4 years.

Early completion of the formation of nutrient fluid in the breast is carried out against the background of a new pregnancy or in case of violations hormonal background(primary hypogalactia). With primary hypolactia, milk production is significantly reduced, creating the appearance that lactation has involution. If this happens at the age of 1-1.5 years, to say that you have involution means to deceive yourself.

Most often, from the age of two, the child switches to "adult" food at the decision of the parents.

Increased sucking activity

When the lactation period approaches its end, the amount of milk decreases and the child does not eat up. The baby increasingly asks for breasts, diligently sucks it out, switches to another, and does not let go for a long time. The baby can suck even an empty breast, waiting for the release of milk. The period of such activity stretches for several months and depends on how long the entire lactation period lasts and how often the baby is applied to the breast.

mom tired

Psycho-emotional and physiological fatigue comes from the fact that breastfeeding can last up to 2-4 years. busy lifestyle, continuous work the body to produce milk provoke dizziness and weakness, which are felt after feeding. The approach of the final stage causes pain in the mammary gland, the nipples also hurt, and general discomfort is felt. Feeding time begins to annoy, there is a desire to stop it. General state during this period can be compared with the initial stages of pregnancy, when fatigue, irritability, and drowsiness pile up. Possible violations menstrual cycle.

At some point, the mother stops enjoying the process of feeding and wants to stop it completely.

Psychological fatigue of both participants in the process

No matter how long breastfeeding lasts, there comes a time when both its participants, mother and child, are tired and psychologically ready to refuse it. We must not forget that breastfeeding itself plays an important role in the development of the baby, not only as nutrition, but also gives a great psychological help. Pleasant moments of close contact have a beneficial effect on the psycho-emotional state of the parent and her little treasure. If it is difficult for the baby to abruptly throw the breast, he does not sleep well, is naughty without sucking milk, it is obvious that the moment for refusal has not yet come. So it turns out that both decisions - for and against breastfeeding, are given with difficulty.

Breast milk is produced by special cells of the glandular (secretory) tissue of the mammary gland - lactocytes under the influence of female hormones. reproductive system progesterone and estrogen during pregnancy. At the same time, the glandular tissue of the mammary gland grows, and from the second half of pregnancy, secretory cells begin to produce colostrum, which, three days after birth, passes into transitional, and then into mature breast milk.

Breast milk is produced by secretory cells located in the glandular tissue of the breast (lactocytes) under the action of the hormone prolactin, the level of which rises after the start of breastfeeding. It stimulates the production of breast milk necessary for the next feeding of the baby.

Also, a specific inhibitor is determined in breast milk, biologically active substance inhibitory milk production - FIL (factor inhibiting lactation). The longer breast milk is in the mammary gland and is not removed from it during sucking or pumping, the stronger the effect of this factor, which leads to inhibition of the production of breast milk by lactocytes. This mechanism protects the mammary gland from overfilling of the ducts and trauma to the glandular tissue, and also allows the baby to independently regulate the intensity of milk production. mammary glands. As the demand for milk increases, the baby suckles more frequently, harder and longer, so the milk (and the inhibitor) is removed more intensively, and the rate of milk production increases, and the baby receives more milk. This regulatory mechanism is also activated when expressing breast milk, when at a certain point the child cannot be breastfed:

• according to indications from the mother (treatment with various drugs, infectious diseases, complications after childbirth);
• indications from the child (weakness and prematurity, diseases of the central nervous system).

In this case, the inhibitor is also removed from the breast along with milk, and the rate of milk production increases.

The release of breast milk from the mammary glands occurs under the influence of another hormonal factor - oxytocin, which is reflexively produced by the mother's pituitary gland when the baby is sucked.

Breast milk: types

Colostrum

This type of milk is produced by the mammary glands in small quantities in the second half of pregnancy and after the birth of a child and is considered the earliest milk - they are fed to the baby immediately after birth (often in the delivery room). Distinctive indicators of colostrum and mature milk are:

• more proteins;
• less fat, but more calories;
• more trace elements and fat-soluble vitamins (groups A, E, K), as well as vitamin C and less water-soluble vitamins;
• less lactose (milk sugar).

Colostrum is produced in smaller amounts than mature milk, but is addictive digestive system baby to new conditions of functioning.
Colostrum also contains high level all protective components - immunoglobulins and active leukocytes, therefore this food product is considered immunostimulating and protective medicine which is vital for a newborn.

transitional milk

Transitional milk begins to stand out after childbirth from 4 - 5 days until the end of the second week. It has more fat than colostrum and gradually begins to approach mature milk in basic composition.

mature milk

Mature milk begins to be produced from the end of the 2nd week. But in the process of lactation, its qualitative composition also changes and can be different during the day, and sometimes even during one feeding. It depends on many factors (nutrition and drinking regimen of a nursing mother, her psycho-emotional state). It is also noted that at the beginning of feeding (the first portions) - the milk is more liquid (it is recommended to express them), by the end of sucking - the milk is thicker and fatter (feeding cannot be interrupted until the baby quits the breast, and it is also recommended to start the next feeding from the breast, which the child was previously fed).

Colostrum

Colostrum is the first milk that is produced by the lactocytes of a woman's mammary gland immediately after the birth of a baby, and sometimes even from the second half of pregnancy (in various volumes - from a few drops to complete filling of the milk ducts). Before the production of mature milk begins, the baby feeds on colostrum, which is a rather thick liquid and can have a color from bluish-transparent to yellow-orange.

This product has a high nutritional value and is easily digested in the gastrointestinal tract, therefore it is considered the most proper nutrition for a newborn. Colostrum prepares the baby's digestive system for more efficient absorption of transitional and mature breast milk. Colostrum is rich in proteins essential amino acids and vitamins, but less fat. With the help of this indispensable food product of the newborn, the intestines are colonized beneficial bacteria. Colostrum has a mild laxative effect, which promotes the release of original feces (meconium) and the removal of bilirubin from the baby's body, which is formed during the breakdown of fetal hemoglobin, preventing the development of jaundice in newborns.

Colostrum is produced immediately after childbirth in a very small amount - sufficient for the child and invisible to the mother. Moreover, if the baby is actively sucking the breast, the newborn has meconium and urination is present - colostrum is produced in enough. Therefore, it is important from birth to feed the baby on demand:

• with a rare attachment of a newborn to the breast (less than eight times a day), hypoglycemia may develop in the baby (a drop in blood sugar levels);
• frequent breastfeeding contributes to uterine contraction after childbirth;
• active sucking of the newborn stimulates the breast, which contributes to the production of milk.

The initial volume of the stomach of a newborn does not exceed one teaspoon, while the saturation of the child is ensured by a high nutritional value colostrum, so the amount that the baby receives when breastfeeding on demand is enough for normal functioning digestive system and normal weight gain. At the same time, physiological weight loss from 5 to 7% on the second - fourth day of life is considered normal, therefore supplementary feeding with a mixture is not required. Weight loss over 8% is:

• a signal of the presence of a pathological condition;
• improper organization of feeding;
• sign of ineffective suckling.

In these conditions, consultation with a pediatrician is necessary.

Colostrum is gradually replaced by mature breast milk. After three days, transitional milk appears in the breast - it is more liquid compared to colostrum, so the volume of one feeding increases. And by the end of the second week of a baby's life, transitional milk turns into mature milk. An increase in milk production is noticeable in the condition of the breast - it becomes heavier and swells. If the baby immediately after birth is given the opportunity to breastfeed on demand (according to the WHO breastfeeding principles) - as much as he needs to saturate - from 8 to 12 times a day, which stimulates the production of milk by secretory cells.

Breast milk: properties and composition

The composition of mature breast milk fully meets all the needs of the baby in quantitative and qualitative composition, changes as the child grows, and cannot be compared with any of the existing infant formulas, even fully corresponding to it in composition.

The main components of breast milk are:

Fats

These components are considered to be the most variable ingredients in breast milk as the fat content of breast milk changes both during one feed, throughout the day and as the baby grows (according to its energy needs). Breast milk is many times superior to cow's milk and adapted milk formulas in terms of the structure of fats, which are better absorbed. It also contains the enzyme lipase (enzyme) - a substance that helps digest fats, which are almost completely absorbed by the body. It also contains essential fatty acid, which are part of the sheaths of nerve fibers, which provide the passage of nerve impulses.

At the beginning of feeding, mother's milk is much poorer in fats - it's like skimmed or skimmed milk, but gradually the amount of essential fats increases - their largest amount is in the last portion of milk: "cream". This portion of breast milk contains a “saturation factor” that makes the baby feel full and he will stop breastfeeding.

It is important to know that a child cries not only when hungry, but also when thirsty or demanding attention and protection (an emotional reaction when you want to be picked up).

When thirsty, the baby suckles the breast for several minutes and is quite satisfied with the first portions of milk with low content fat, but if the baby is hungry, he will suckle the breast until he is completely saturated.

Squirrels

These high quality components are the basis for growth and proper development baby's body. Proteins play an important role in the first year of a child's life, when he grows faster than in any other period of development. Breast milk, like any other, contains two main proteins - casein and whey protein. Whey protein is easily absorbed in the intestines of the baby, and casein is a protein that is involved in the curdling of milk, but is more difficult to digest. Mother's milk contains more whey protein. This significantly distinguishes it from cow's and goat's milk, which contain more casein, as well as from milk mixtures. Also, breast milk, in addition to whey protein, contains other proteins that are usually absent in goat and cow milk, as well as in infant formulas, these include:

• taurine - a protein that improves the development of the brain and peripheral nervous system;
• lactoferrin is a specific protein that helps with the transport and utilization of iron from breast milk, and also inhibits the activity of pathogenic bacteria and fungi in the intestine.

Breast milk contains lysozymes - special enzymes and natural antibiotics that contribute to the destruction of pathogenic microorganisms.

Human milk proteins are easily digestible compared to cow's and goat's milk proteins, as well as the protein components found in formula milks. Therefore, breast milk stays in the baby’s stomach for a short period of time, quickly entering the intestines, and the milk formula lingers in the stomach for 2-3 hours, in connection with this, it is recommended to feed the babies with the mixture at certain intervals (according to the regimen), and with natural feeding - without restrictions (on demand). At the same time, it is important to remember that a long stay of the baby at the breast and frequent feeding of the baby can lead to overfeeding - regurgitation and intestinal colic. It is important to remember that the crying of a baby is not always a desire to eat - there may be other reasons for the baby's anxiety (pain, temperature, cold or heat, thirst), as well as a lack of milk in case of hypogalactia, mastitis and lactostasis.

Sugar (carbs)

Human milk contains 20-30% more milk sugar (lactose) than animal milk. To bring adapted milk formulas to taste closer to breast milk, glucose or sucrose is added to them. At the same time, milk sugar has a greater energy value and is important for the development and differentiation of neurons in the brain and central nervous system of the baby. Lactose improves calcium absorption and promotes the growth of positive intestinal microflora.

Iron

Protective substances

Mother's milk contains components that are unique in their structure and properties, capable of destroying infectious agents and preventing the development and progression of viral, bacterial and fungal infections in the body of a newborn and infant. These include leukocytes - killers and helpers (white blood cells), as well as immunoglobulins (antibodies). Therefore, it is considered that the best protection for the baby is mother's milk, which is able to protect the child from all diseases until he develops immunity.

Breast milk: pumping

To date, pumping is not carried out unnecessarily - this prevents self-regulation of lactation. The mother produces breast milk as much as the child needs, and when decanting milk residues after each feeding, more mother's milk arrives, and this leads to lactostasis, and then mastitis.

But there may be situations when pumping is necessary:

• when the baby is weak or premature and cannot suck on his own;
• when a newborn or baby refuses to suckle;
• in diseases of the mother, when feeding is impossible for a certain time, but it is important to maintain lactation;
• a woman has developed lactostasis or mastitis and it is necessary to “drain” her breasts;
• mother needs to be away from home (to work or study) and milk must be stored for future use.

Expression of breast milk is carried out by hand or with a breast pump.

Before starting manual pumping, it is necessary to stimulate the reflex separation of milk. by easy breast massage or warm shower. When decanting, fingers should be placed on the border of the areola and nipple from above and below, and then rhythmically press inward and forward, without stopping rhythmic movements. At first, milk is released in drops or weak streams, and as the pumping movements continue, the milk begins to flow in several streams until the milk release completely stops - then the pumping of the other breast begins.

Storage of expressed milk

But there are situations when the mother needs to leave, undergo treatment or interrupt maternity leave to go to work, temporarily stop feeding and get an answer to the question - wean the baby from the breast and transfer to artificial feeding Or continue breastfeeding with expressed breast milk? The answer is accepted depending on the situation with the help of a lactation consultant (pediatrician or family doctor). When breastfeeding with expressed milk, breast milk must be stored properly. But at the same time, it must be remembered that, depending on the chosen method of storing this product, its composition and shelf life may change.

Store breast milk expressed only in the refrigerator or freezer, and is strictly prohibited when room temperature except when using it soon. It can be stored in the refrigerator for no more than two days, and for long-term storage (3 months), mother's milk is frozen in the freezer in portions, in sealed (special) tightly closed containers: bags or containers. Defrosting of breast milk should be carried out at room temperature or when placed in a container with warm water, and it is not recommended to use for this purpose microwave oven. Thawed milk differs from fresh milk in taste and has a "stratified" appearance. Re-freezing of breast milk is not allowed.

Storing breast milk outside the refrigerator

The storage time of expressed breast milk at a temperature of 16 to 26 ° C should be no more than 3-4 hours, and then all its antibacterial and protective properties gradually decrease (some sources describe the shelf life of this food product at room temperature up to 6 hours, but while all of it beneficial features change significantly). Therefore, the best way to preserve all the quality indicators of mother's milk is to store it properly - in the refrigerator or freezer.

Storing breast milk in the refrigerator

When storing expressed breast milk in the refrigerator, it is used when it is used within a week, while it is better to store it in the main compartment of the refrigerator. At the same time, many studies show that there are significantly fewer pathogenic bacteria in chilled breast milk than immediately after pumping (!) And this is due to active work macrophages - cells that kill pathogenic microorganisms. Freezing kills macrophages. This storage method is considered the most preferred for expressed breast milk.

Freezing breast milk

Freezing of mother's milk is carried out at a temperature of -13-18˚C, breast milk can be stored in a conventional freezer for up to 3-4 months, and with deep freezing and a constant storage temperature: -18˚-20˚C, expressed milk can be store for 6 months or more.

Reading time: 8 minutes

Mother's milk is a unique element of raising a child, which is perceived as a natural given, and therefore even experienced mothers rarely think about its features. However, knowing the composition of breast milk, mothers could correctly relate to the duration of feeding, the nature and intensity, which would surprisingly affect the health of entire generations of people. This information is necessary for future and current mothers.

What is breast milk made of

The breastfeeding system is a well-calibrated mechanism that fully provides the newborn with the necessary substances, protection, and gives him everything that is necessary for normal growth and development. This system is adapted to the needs of the child, and therefore the composition of milk is always different, even with daily feeding. The main components of mother's milk are water, proteins, fats, carbohydrates, vitamins, minerals, macro- and microelements, each of which performs its own important features in the process of formation and protection of the baby's body.

Water

Breast milk consists of water - it contains 87% of it, which fully provides the baby with the necessary moisture, regardless of temperature regime. Since mother's milk is both food and drink for the baby, he himself must regulate the intake of milk, "asking" the mother to feed if there is a need for food or water. Therefore, the child cannot be fed less often than he asks, because. in addition to a lack of nutrients, he may become dehydrated. If you feed on demand, you will not have to supplement the baby.

Squirrels

Proteins in breast milk make up the smallest part - only 1%. All this is due to the fact that the child's body needs proteins only in a small amount. For baby the norm is 1% of the total body weight, and over time - even less. Too much protein can be harmful and even dangerous. But the mother's body itself adjusts to the amount of this substance in milk that is necessary for the child, eventually changing its composition to less protein.

Mother's milk contains the following types proteins:

Fats

Fats are important component breast milk, which is involved in the construction of the nervous system of the child. They saturate the body with biological energy and are responsible for good mood. A woman's breast milk, along with goat or cow milk, has a fat content of 2 - 4.5%, is in perfect balance with carbohydrates, and is uniquely suited to the needs of her child.

The fat content of a woman's milk is not uniform: milk, accumulating before feeding, flows down to the nipple with its watery part, while the fats remain behind. This is how the concept of "forward" and "hind" milk appeared.

• Foremilk - less fat, saturates the baby with moisture.
• The back is fatter, reaches the nipples after 15 minutes of feeding and saturates the baby nutrients. Therefore, in order for the baby to receive all the substances he needs, feeding must be long (last at the request of the baby).

Unsaturated and saturated milk are equally important because each is responsible for his own type of work: unsaturated - for the development internal organs child, saturated - for the construction of the nervous system. In order for milk to be well digested, the enzyme lipase is provided, which helps the baby break down fats.

Carbohydrates

Carbohydrates in breast milk contains 7%. Most of them are lactose: a specific carbohydrate, which is found only in mother's milk, contributes to the development of the child. Action spectrum:

• brain development;
• formation of an environment for the development of bifidobacteria;
• promoting the absorption of calcium and iron.

To break down carbohydrates, mother's milk contains the enzyme lactase, which the baby can only get from hind milk. In order to avoid poor absorption of lactose, the child needs to be fed for a long time, more than 15 minutes with one breast, or at the request of the baby. In addition to lactose, breast milk contains galactose, fructose, oligosaccharides, which also play an important role in the development of the child.

Hormones

A mother's breast milk contains hormones that a baby needs to normal development physical body, mental state– more than 20 species in total. It will not work to replace them with something else, because. Any hormone given artificially can bring down the processes of the baby's body that are properly regulated by nature. Therefore, breastfeeding is extremely important.

Hormones and other substances (trace elements and vitamins) account for only 1% of mother's milk, but their role is irreplaceable. All of them are aimed at organizing the proper development of the child's body, the formation of a healthy psycho-emotional state and regulatory function. Breast milk contains hormones:

• oxytocin (the love hormone responsible for the psycho-emotional health of the child);
• growth factor;
• prolactin (development of the pituitary gland and reproductive function);
• insulin (blood sugar regulator);
• sex hormones;
• thyroid hormones;
• prostaglandins and others.

Vitamins, minerals and trace elements

In breast milk, in addition to other substances, contains the necessary specific child the amount of vitamins, minerals, trace elements. These are iron, phosphorus, copper, manganese, cobalt, vitamins of groups A, B, C, D, minerals, salts. With a good nutrition of the mother, their ratio is ideal.

Most of these substances are found in foremilk and are inactive. But, accumulating in the baby's body, they move to the active phase as needed. Therefore, expressing foremilk is highly discouraged in order to avoid beriberi and other malfunctions of the child's body.

Together with hormones, these substances in mother's milk make up 1%, but this is enough for the baby, because. they are absorbed by 80%. What can not be said about vitamins in tablets, dry mixes and ordinary food. For example, iron in mother's milk is absorbed by a child by 70%, and contained in a dry mixture - only by 10%. Therefore, a high percentage of vitamins and other elements are added to the mixture, and this is harmful, because. increases the load on the body of the baby.

What is colostrum and what are its benefits

Colostrum is a type of breast milk that is secreted from the mother during the third trimester of pregnancy and a few days after childbirth. It is a yellow sticky liquid with a high concentration of substances necessary for the child, which are in the most digestible form. Colostrum is vital for the newborn as it it fully nourishes without burdening the intestines and other organs that the baby has not yet grown stronger.

Colostrum has the following properties:

• It is a transitional form of nutrition - from intrauterine to mature lactation.
• It consists of substances that are as similar as possible in structure to the tissues of a newborn (sugar = lactose, proteins = blood serum proteins, fats are oleic acid high in phospholipids).
• Contains the maximum amount of: proteins (4-5 times more than in ordinary milk), vitamin A and β-carotene (2-10 times more), ascorbic acid(2-3 times more), secretory immunoglobulin A, mineral salts.
• It has high calorie content: changes from 150 to 70 kcal/100 ml during the first 5 days of excretion from the breast.
• Gives immune protection to the newborn, promotes the formation of local immunity.
• Envelops the walls of the gastrointestinal tract, preparing for the transition to "mature" milk.
• Facilitates the excretion of meconium (faeces of a newborn).
• Eliminates the risk of metabolic stress that could result from processing a large number liquids.

The high concentration of essential substances allows the child to eat even 50-100 ml of colostrum per day.

Table - the chemical composition of breast milk

Component	Average values ​​for mature breast milk
Energy (kJ)
Carbs (g)
Sodium (mg)
Calcium (mg)
Phosphorus (mg)
Iron (mcg)
Vitamin A (mcg)
Vitamin C (mcg)
Vitamin D (mcg)

What is the difference between the composition of breast milk up to 6 months and after

The composition of a mother's milk changes as she grows older baby. With growth, the baby's body is rebuilt and needs some substances more and others less. The mother's body adapts to the needs of the child. And the composition of milk varies depending on the needs of the baby.

The main difference in the composition of mother's milk after 6 months is a decrease in the amount of fats and proteins, an increase in lipids and carbohydrates. The energy value increases, which is what the development of the baby requires. The content of some vitamins, minerals and other substances also changes depending on the need in a given period of a child's life. For example, if the teeth climb, the calcium content increases.

Feeding a baby after 6 months is extremely important, because. milk continues to build immunity, provides nutrients, vitamins, enzymes and other useful substances by a third or more. However, from this time on, the child can be offered additional food (mixtures, regular products). What the baby will like is what he needs most.

Does the content change after a year of feeding

The composition of mother's milk changes throughout the feeding period. After a year, it increases its energy value, increases the content of vitamins and antibodies, because the child's body has become larger, which means that the needs have grown. In total, on average, mother's milk after a year provides the child with useful substances in the following proportion: nutrients by 35%, vitamin C by 60%, vitamin A by 75%, vitamin B12 by 94%, calcium by 36%, derivatives folic acid- by 76% based on the daily rate.

Analysis of the constituents of mother's milk

Usually, the breastfeeding system is a well-defined mechanism, in which it is better not to interfere, but to let nature regulate everything on its own, but still there are cases that make you wonder if everything is in order with milk. In order to stop worrying, mothers can take their milk for analysis. This must be done exactly if:

• the woman had mastitis;
• in the first 2 months, the child has persistent diarrhea with dark green liquid feces and an admixture of blood with mucus.

What affects the composition of mother's milk, find out from this video:

When organizing feeding, you should always remember that nature provides for everything: it is worth breastfeeding a child as long as there is a need for it. Let your baby get enough of all the substances he needs that nature has prepared for him so that he can grow up to be a healthy, intelligent and psycho-emotionally balanced person.