Breastfeeding Basics: Physiology

More interesting tidbits from the Breastfeeding Basics learning module that I am taking for my doula certification.

1. Can I breastfeed if I've had breast augmentation?
It depends.

Women who have breast augmentation surgery have a higher incidence of insufficient milk supply. The effect on milk supply depends on the type of incision, cutting the nerves to the nipple-areolar area, the implant type and placement, and any surgical complications. Breast size increases with pregnancy. Consequently, women requesting breast augmentation prior to becoming pregnant, must be counseled on the possible effect of the surgery causing decreased milk supply when lactating in the future. Breastfeeding an infant from breasts with silicon implants in place appears to have no harmful effects on the infant.

Much of this also applies to breast reduction surgery. 


2. The onset of lactogenesis (the production of breast milk) has been shown to be delayed by stressful events around delivery. Women who underwent an urgent Cesarean section or had a long duration of labor before vaginal deliveries were more likely to have a delayed onset of breast fullness in the first days after delivery.


3. How soon after birth will I be producing milk?

Colostrum is a thick, yellowish milk that is secreted by a woman's breast in the first several days after delivery.  Due to its high concentration of antibodies, this milk is particularly valuable for infants in preventing infection.
Transitional milk is secreted between about four days and ten days postpartum. It is intermediate in composition in between colostrum and mature milk. The volume increases during this time.


4. Human breast milk is the ideal form of nutrition for infants. Only the following supplementation is generally recommended:

1. All infants should receive a Vitamin K supplement in the immediate postpartum period.
2. Supplementation with 400 IU of Vitamin D is recommended for all breastfed infants.
3. Women who are breastfeeding should continue their prenatal vitamins for the vitamin D, calcium and iron that they supply.
4. Once infants reach six months of age supplemental foods should be added. These should include foods rich in iron.