INTRODUCTIONDEFINITIONS: • LACTATION describes the secretion of milk from

the mammary glands. This process occurs in all female mammals and it is in only 1 species of mammals (Dayak fruit bat) that it is a normal process in the male.

• GALACTOPOEISIS is the maintainance of milk production.

• GALACTORRHEA is milk production which is unrelated to nursing (breastfeeding) as occurs in the male Dayak fruit bat.

HORMONAL REGULATION OF LACTATION

• From the 24th week of Gestation, a woman’s body produces hormones that stimulate growth of milk duct system in breasts

• PROGESTERONE: This hormone influences the growth in size of the alveoli and lobes; high levels before birth inhibit lactation and low levels after birth triggers lactation.

• ESTROGEN: Stimulates growth and differentiation of milk duct system.

• PROLACTIN: Increases growth & differentiation of alveoli & differentiation of the ductal structures. It is the main factor that maintains tight junctions between alveoli and ducts during lactation.

• OXYTOCIN: After birth, it contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly produced milk into the duct system.

• HUMAN PLACENTAL LACTOGEN: It is important in breast nipple and areola growth before birth

NB: Lactation increases consequently with increased consumption of the milk.

COMPOSITION OF BREAST MILK

I PROTEINS THEY ARE OF TWO MAIN TYPES; 60% WHEY PROTEIN & 40% CASEIN

A) LACTOFERRIN INHIBITS THE GROWTH OF IRON-DEPENDENT BACTERIA IN THE G.I.T

B) SECRETORY IgA, IgG & IgM HELP TO PROTECT THE INFANT AGAINST MICROBES, ESPECIALLYTHOSE WHICH THE MOM AND FAMILY ARE EXPOSED TO.

C) LYSOZYME PROTECTS AGAINST E-COLI & SALMONELLA AND HAS ANTI-INFLAMMATORY FUNCTIONS

D) BIFIDUS FACTOR SUPPORTS GROWTH OF LACTOBACILLUS, IT CREATES AN ACIDIC ENVIRONMENT WHICH INHIBITS GROWTH OF HARMFUL BACTERIA.

II FATS

THEY INCLUDE; LONG CHAIN FATTY ACIDS ESSENTIAL FOR BRAIN DEVELOPMENT, RETINA AND PROPER NERVOUS SYSTEM DEVELOPMENT.

III VITAMINS THE CONTENT AND AMOUNT OF VITAMINS IN BREAST MILK DEPENDS ON THE MOTHER’S INTAKE

IV CARBOHYDRATE LACTOSE IS PRIMARY CARBOHYDRATE CONTENT ( ACCOUNTS FOR 40% OF THE CALORIES PROVIDED BY BREAST MILK). IT HELPS TO REDUCE THE AMOUNT OF UNHEALTHY BACTERIA PRESENT IN THE G.I.T, IMPROVES ABSORBTION OF CALCIUM, PHOSPHORUS AND MAGNESIUM, PROMOTES GROWTH OF HEALTHY BACTERIA

NOTE A – NON-PROTEIN NITROGEN-CONTAINING COMPOUNDS MAKE 25% OF TOTAL MILK’S NITROGEN & INCLUDE UREA, URIC ACID , CREATINE, CREATININE, AMINO ACIDS, AND NUCLEOTIDES B- MOTHER'S MILK HAS BEEN SHOWN TO SUPPLY A TYPE OF ENDOCANNABINOID (THE NATURAL NEUROTRANSMITTERS THAT MARIJUANA SIMULATES), 2-ARACHIDONOYL GLYCEROL.

C- A NEWLY DISCOVERED PROTEIN COMPLEX IN BREAST MILK CALLED HAMLET WAS FOUND TO HAVE A QUITE IMPORTANT FUNCTION. FURTHER RESEARCHES SAY THIS COMPLEX IS FORMED WHEN ALPHA-LACTALBUMIN (A PROTEIN) UNFOLDS INTO A DIFFERENT FORM AND BINDS WITH OLEIC ACID (FATTY ACID). HAMLET WAS FOUND TO BE LETHAL TO TUMOUR CELLS & TO INCREASE BACTERIA’S SENSITIVITY TO DIFFERENT CLASSES OF ANTIBIOTICS. THIS IS VERY IMPORTANT AS IT MINIMIZES THE CONCENTATION OF ANTIBIOTICS WE NEED TO FIGHT AGAINST BACTERIA THEREBY REDUCING RISKS OF INTOXICATION BY THE ANTIBIOTICS.

Colostrum has laxative effect.

The composition of Breast Milk changes with time

according to the needs of the infant.

Easier to digest especially for premature babies.

Primary protection from disease.

Growth factors presesnt stimulate development of the G.I.T.

Hormones present are important for development of the child.

BENEFITS FOR MOTHER.

( 3) RELAXES BOTH INFANT & MOTHER.

(1) MAKES LIFE

EASIER.

( 2 ) SAVES MONEY.

( 4 ) CAN SERVE AS

CONTRACEPTIVE METHOD.

• EFFECTIVE ROLE IN POST PREGNANCY WEIGHT LOSS.

• LOWER RISK FOR IRON

DEFICIENCY ANAEMIA.

• LOWER RISK FOR POST-PARTUM HEMORRHAGE.

• REDUCED RISK OF

REPRODUCTIVE/OVARIAN

& UTERINE CANCERS.

• FOR MOTHERS WITH TYPE 1 DIABETES.

• Need less insulin shots while breast feeding .

• They achieve optimal weight loss.

• Reduced risk of heart problems.

It helps to create mother - child bond due to effects of Prolactin & Oxytocin secreted during breast feeding.

BENEFITS FOR THE SOCIETY.

• Nations save money which can be implemented into budget for other sectors like education, agriculture, research….

• More productive work force.

• Environmental friendly : less non-biodegradable waste.

DURING EMERGENCY SITUATIONS.

• Breast feeding prevents dehydration of the infant when there is no

access to clean water.

• Helps protect against respiratory diseases & diarrhoea in a crowded

environment |( eg. Shelters.)

• Helps to prevent hypothermia when baby temperature drops.

• Readily available when family is stranded without access to supplies.

FACTS ABOUT BREAST FEEDING.

If 90% of families in USA

exclusively breast fed for 6

months.

= 1000 less infant deaths/yr

=$13billion saved per year.

200-500 calories is used

up/day during breast

feeding.

= swimming 30 laps at the

pool.

= cycling uphill for one

hour.

CONCLUSION

AS FUTURE DOCTORS, IT IS OUR DUTY TO ADVICE OUR PATIENTS ON THE BENEFITS OF BREAST FEEDING OVER FORMULA FEEDING.

AS FUTURE PARENTS, IT IS AN OBLIGATION FOR US TO FOLLOW THE RULES OF BREAST FEEDING PROVIDED THERE IS NO CONTRAINDICATION.

PERSPECTIVES I

THE FINDINGS HOLD GREAT PROMISE IN AN ERA WHEN HOSPITALS ARE STRUGGLING TO CONTAIN DRUG-RESISTANT BACTERIA.

II

WE BELIEVE THERE ARE STILL A LOT OF FACTS ABOUT BREAST MILK TO BE DISCOVERED WHICH COULD BE REVOLUTIONARY TO GENERAL MEDICINE AND EVEN CLINICAL PRACTICE.

WHEN NOT TO BREASTFEED.

• IF THE MOTHER IS INFECTED WITH HIV OR HAS AIDS.

• WHILE TAKING SOME MEDICATIONS WHICH CAN HARM THE

BABY.

• MOTHERS UNDERGOING CHEMOTHERAPY SINCE THIS CAN

SEVERLY DAMAGE THE GROWTH OF THE BABY.

• MOTHERS UNDERGOING RADIATION THERAPY ESPECIALLY

OF THE CHEST.

• MOTHERS WITH UNTREATED AND ACTIVE TUBERCULOSIS.

• MOTHERS TAKING DRUGS LIKE COCAINE, MARIJUANA,

HEROIN…

• BABIES WITH GALACTOSEMIA WHEREIN THEY CANNOT DIGEST OR TOLERATE BREAST MILK.

• MOTHERS UNDERGOING RADIATION THERAPIES ESPECIALLY

OF THE CHEST.

NOTE : DURING SIMPLE INFECTIONS & &AILMENTS LIKE

COMMON COLDS, FLU, G.I.T INFECTIONS….. BABIES CAN BE

BREASTFED IF PROPER PRECAUTIONS & HYGIENE MEASURES

ARE FOLLOWED.

IT IS ADVANTAGOUS BECAUSE BREAST MILK WOULD CONTAIN

ANTIBODIES AGAINST THE INFECTION PASSIVE

IMMUNITY FOR THE BABY.

WHEN

THANKS FOR YOUR ATTENTION.