Breast Physiology And Lactation

Question 1

When does colostrum begin to be created?

Answer 1

Any time from 16 weeks

Question 2

List some of the changes that can occur to the breasts during pregnancy

Answer 2

• Increased vascularity
• Thickening of the nipple skin
• Full development of the lobules
• Dilation of the alveoli and ducts
• Pigmentation of the nipple and areola
• Secondary areola may appear (usually with darker skinned women)
• Montgomery’s tubercles become prominent
• Small amounts of colostrum are secreted/expressed in latter pregnancy

Question 3

What does each breast contain?

Answer 3

1 x areola: produces lubrication during lactation
1 x nipple: which milk is excreted
Many alveoli: milk is produced
Tubules and ducts: through where milk passes from the alveoli to the nipple (Montgomerys tubules)

Question 4

Which ribs do the breasts extend from? And where do they go to and from laterally?

Answer 4

2nd to the 6th rib

Laterally: sternum to axilla

Question 5

What does the connective tissue do in the breast?

Answer 5

Runs through the breast to aid support

Question 6

What is the nipple composed of?

Answer 6

Muscle fibres which act like a sphincter to prevent leakage

Question 7

What is found in the openings of the areola?

Answer 7

Sebaceous glands and Montgomerys tubules which secret a lubricant to aid breast feeding

Question 8

What does each lobe contain?

Answer 8

A lactiferous tubules - this is where milk is stored
Lobes are divided into lobules which contains a lactiferous duct, between each of these is a various amount of adipose tissue

Question 9

How does the ratio of glandular to fat tissue alter in pregnancy?

Answer 9

From 1:1, to 2:1

Question 10

Where can you find alveoli?

Answer 10

Clustered around lactiferous ducts and they contain milk producing acini cells

Question 11

What is the role of of the acini cells

Answer 11

These cells extract the necessary nutrients for milk production via the network of capillaries surrounding the alveoli into the lactiferous ducts

Question 12

What happens to progesterone, oestrogen and prolactin levels after the 3rd stage?

Answer 12

Progesterone ⬇️
Oestrogen ⬇️
Prolactin ⬆️

Question 13

Where is prolactin produced and what is its role in breast feeding?

Answer 13

Produced from the anterior lobe of the pituitary - aids the production of milk

Question 14

Where is oxytocin produced and what is its role in breastfeeding?

Answer 14

Produced from the posterior of the pituitary and is involved with the ejection of the milk

Question 15

What else apart from prolactin stimulates the production of breast milk?

Answer 15

Suckling from the neonate at birth

Question 16

How many lobes does each breast have?

Answer 16

Between 4-18

Question 17

Describe the process of stimulating breast milk

Answer 17

1. Release of oxytocin
2. The release acts on myo-epithelial cells which surround the alveoli
3. These cells contract and expel milk through the alveoli and lactiferous ducts
4. Suckling from the baby initiates the let down of milk

Question 18

What is feedback inhibiter for lactation

Answer 18

A whey protein found in breast milk
Regulates the amount of milk supplied
It encourage the suppression of milk production in large amounts

Question 19

What is cessation of breast feeding

Answer 19

Involution of lactation

Takes normally 40 days after the last feed

Question 20

What is important for the feedback inhibitor for lactation

Answer 20

It needs a constant contact with the cell walls in order to successfully cease breast feeding

Question 21

Name 5 things about the composition of breast milk

Answer 21

• Transparent and yellow in colour
• Has a higher protein content than formula milk
• Contains immunoglobulins which increase prevention of infection
• Neonates take very small amounts
• Carb and fats levels are lower than in breast milk

Question 22

What does breast milk do with its composition which is very intelligent

Answer 22

It varies in composition in order to provide the appropriate nutrients the infant needs

Question 23

Name 5 different constituents of breast milk

Answer 23

1. Protein
2. Fat
3. Lactolose
4. Vitamins
5. Minerals