What are Boobs?

Today we’re going to chat about the basics breast anatomy and breastfeeding. In my posts about breastfeeding (part one and part two) I talked about the book Breastfeeding Made Simple,  by Nancy Mohrbacher and Kathleen Kendall-Tackett. In the introduction, Jack Newman, MD described the many reasons why women say that they “can’t” breastfeed (i.e. I don’t have enough milk, breastfeeding imposes too many demands on me, breastmilk isn’t as good as formula, etc.). This post is going to attempt to change that “I can’t” into what it really is, a “I don’t know enough” or “I don’t want to”.

**Disclaimer: Some women physically can’t breastfeed because of cancers or other medical problems. This is not what I’m talking about**

Anatomy of the Breast

anatomy-of-the-breast-diagram

Let’s start at the basic high school biology level the most people don’t actually remember or didn’t care about when they were in school. First you have your chest muscle that you work when you’re doing push-ups, the pectoral muscles. Next are the fatty tissues and lobules. The fatty tissue is a thin, outer protecting layer while the lobules are mammary glands. Then the areola, the dark circular section on your breast, and the nipple.

Now into milk production. I like to think about the process like a river system (my environmental degree kicking in). The Mississippi River doesn’t start out massive as it is when it empties into the Gulf of Mexico.

breast-anatomy

It begins as a little spring trickle that joins another trickle, and another and so on until there’s a flowing creek. Then the creek joins another creek to create a stream. The stream joins another stream and so on until you have the giant Mississippi River entering the ocean. The same idea applies to how you produce milk from your breasts. The alveoli cells secrete milk, and when they create enough it pushes out into the skinny section of the milk duct. Then when that’s full the milk goes into the larger collection section of the milk duct so when the baby suckles at the nipple there’s milk waiting to come out (This is a very basic description, there are many hormones, the milk let down, and other things that affect breastfeeding. I’ll speak to this later on).

Types of Mother’s Milk

  1.  Colostrum – Often referred to as “liquid gold” because of its antibiotic properties. Colostrum is rich in protein and low in fat. This type is usually clear and runny, but can be thick and yellow too. It is present during the last months of pregnancy and the first few days after birth. Most women produce 1-3 ounces per day.
  2. Transitional Milk – The amount of sugar, fat and calories increases. While the amount of protein and antibodies decreases until the level of mature milk is reached.
  3. Mature Milk – There are two parts to mature milk, hindmilk and foremilk. Foremilk is low in protein, fat and calories giving it a runny appearance. Hindmilk is high in protein, fat and calories, giving it a thick creamy appearance. Contains the fat and calories your baby needs to grow

I’d like to put this on a timeline for you, I’m a more visual learner so everything makes sense to me if I can actually see it. So, if you’ll look below:

Transition of Breastmilk.jpg

Now as you can see it takes a little bit for the mature milk to come in but that doesn’t mean that the colostrum and transitional milk aren’t important. Completely opposite in fact: they are the best thing for your newborn at this time. Why? Because your baby is practically born without an immune system, they only have the very basics and the colostrum is what provides them with all of the antibodies that will protect them in the outside world. Colostrum also helps prevent newborn jaundice because it has a ‘clean you out’ affect that gets your baby’s gut into working order, it also is why your baby’s first poops are dark and sticky. The transitional milk is what helps prepare your baby’s stomach for the mature milk and still has all of the important antibodies.

When your mature milk (finally?) comes in you may still be feeling a little bit timid about the whole process. Once you and your baby click together and really get a handle on it, breastfeeding will seem easy and natural. But is your baby getting enough milk (?) and is it the right type of milk? What I mean is that if your baby isn’t latched properly or if there’s another issue then they may only be getting foremilk. Foremilk is for hydration: this is your baby’s drink. Hindmilk is where all of the calories and proteins are: your baby’s real meal. If they are only getting foremilk then they won’t be gaining weight or pooping as much as they should (I’ll get into the signs of under and over feeding later).

Fore versus Hindmilk.jpg

The milk ejection reflex, more commonly known as your milk letting down, is something that some mothers feel but some don’t. Essentially, what happens is that when your baby is stimulating your nipples {by suckling} it goes up to your head into your hypothalamus. The hypothalamus then tells the posterior pituitary gland to produced Oxytocin which causes the milk ejection reflex (AKA let down). It also tells the anterior pituitary gland to produce Prolactin which is the hormone that starts milk production.

X2604-L-04.png

Is Your Baby Getting Enough?

The real question everyone always wants to know is if their baby is getting enough to eat and drink? Let’s first look at how much your baby actually need to eat and how much they can eat at a time?

At 1 day old, baby’s stomach capacity is 5-7 ml, also the size of a marble.
By day 3. baby’s stomach capacity is about 0.75-1 oz.
At day 7, your newborns stomach has reached 1.5-2 oz. or about the size of a ping-pong ball.

So with the size of your baby’s stomach in mind, how many times do they really need to eat to get all of the required nutrients? Well the first few days are going to be different then the rest of your breastfeeding relationship. While in the womb, your baby was immersed in amniotic fluid (basically swimming) so they’re a little water-logged. Also they’ve never had to use their stomach and digestive system before because they were getting their nutrients through their blood via umbilical cord. So, in the beginning every few hours for shorter periods of time (keep in mind it may be longer due to them figuring out how to latch properly not because they’re actually eating that long).

Now your milk has come in,your baby’s stomach is large enough, and they have been practicing for a few days; they are ready for some hearty feeding. You notice that they are still feeding for the same amount of time that they were before. This may not be an actual problem: your breasts may be smaller or they don’t have a lot of milk ducts with alevoi cells. Either way you physically can’t hold as much milk as a woman with larger breasts and that’s ok! All it means is that your baby is going to have to eat more frequently. In actuality this is better for your baby because it promotes stable blood sugar and healthy eating habits (like an adult eating many small meals a day versus three giant ones).

 

Ways to Determine if Your Baby is Eating Enough:

Weight gain

The typical newborn will lose up to 7% of their birth weight in the first few days. Baby should regain their birth weight by 10 days – two weeks. Once mom’s milk has come in, baby will gain an average of 6 ounces a week or a pound plus a month.

Dirty diapers

In the early days, baby should have at least one dirty diaper for each day of life (1 on day one and 2 on day two etc.) After day 4 baby should have yellow stools 3-4 times a day that are the size of a quarter.

Wet diapers

In the early days, baby typically has one wet diaper for each day of life (1 on day one, 2 on day two) After moms milk has come in, you can expect around 5-6 wet diapers in a 24 hour period.

  • Day 1: 1 pee
  • Day 2: 2 pees
  • Day 3: 3 pees
  • Day 4: 4 pees
  • Day 5: 5-6 pees
  • Day 6 and beyond: 6+ pees

 

Latching and Positioning

A very important part of your breastfeeding relationship starts with your baby’s latch. If it is incorrect it can cause nipple pain, insufficient milk transfer and many other issues. There are some techniques that can be used when latching baby to your breast, some of which include the positioning of you and baby while at the breast.

Some soreness in the beginning while you and baby are getting used to breastfeeding is normal and will subside in a short amount of time. While you’re waiting, a nipple cream can be useful.

If baby is transferring milk, gaining weight properly and there is no pain in mom, then latch and position are technically good!

Latching and positioning checklist:

  • Baby seems interested (mouth moves/opens, hands wiggle)
  • Clothing out of the way
  • Make yourself comfortable
  • Support your baby – Baby is horizontal, with head, chest, naval, and knees all facing you.
  • Baby’s mouth should be wide open right before latching
  • Baby should suck on a good mouth full breast tissue
    43f7badd1423fe8b9b21a8aebaffcb90.jpg

 

Things you should NOT hear or see while baby is latched

  • If you hear clicking sounds that HURT you
  • Baby’s lips are sucked in

Different breastfeeding positions:

As discussed earlier, frequent nursing is very important for establishing your milk supply. Think 8-12+ nursing sessions in a 24 hour period. Allow unlimited time at the breast each time. Many babies are excessively sleepy so you want to wake baby every 2 hours to nurse.

Issues and Problems

Problem: Cracked or bleeding nipples

  • It is NOT a normal side effect to breastfeeding and should be addressed immediately
  • Usually the cause is improper latch (Try different positions while nursing, see what a correct latch looks like from image above and attempt to emulate)
  • See a Lactation Consultant for evaluation

Problem: Over-active let down or Oversupply – When a mother has more milk than her baby can handle the following issues are most likely to present itself and cause problems. Such as:

  • Baby cries a lot and is often irritable
  • Baby may sometimes gulp, choke or cough during feedings
  • Milk sprays when baby comes off, especially at the beginning of a feeding
  • Mother may have sore nipples
  • Baby may arch and hold himself very stiffly, sometimes screaming
  • Feedings may be short, lasting only 5-10 minutes
  • Spits up a lot
  • Mothers breasts feel very full most of the time

Solution to over-active letdown or oversupply

  • Offer only one breast at each feeding
  • Pump right before nursing to get milk out
  • Try alternating nursing positions

Problem: Clogged/Plugged Ducts

Ducts clog because your milk isn’t draining completely. You may feel a hard lump or soreness to the touch on your breast. Fever and achy feelings are cause for a doctor visit. To avoid this try not having long stretches between feedings. A nursing bra that is too tight may cause clogged ducts as well.

Solution: Apply a warm compress and massage them to stimulate milk flow

Problem: Thrush

Thrush is a yeast infection in your baby’s mouth which can also spread to your breast. It causes itchiness, redness, and soreness.

Solution: You will need to get a prescription anti-fungal from your doctor

Problem: Inverted/flat nipples

Hold your breast at the edge of the areola between your thumb and index finger. Press in gently but firmly about an inch behind your nipple. If your nipple protrudes, that’s great. If it does not protrude or become erect, it is considered flat. If it retracts or disappears, it is truly inverted.

Solution: Use a pump to get the milk flowing before placing baby at your nipple and use breast shells between feeds. Once you feel like your milk supply is adequate, try using nipple shields if baby still has problems latching.

Problem: Tongue tie/lip tie

Tongue tie occurs when the thin piece of skin under a baby’s tongue (frenulum) is too short and restricts movement of the tongue. This occurs in about 5% of people and is more likely to occur in boys than girls. It also may run in families. Some babies with tongue tie are able to breastfeed properly without problems but many cause nipple damage, less milk transfer and low weight gain in baby, and blocked ducts or mastitis due to ineffective milk removal.

Lip tie is the same thing accept that the frenulum is in between the lip and gum area. Similar problems exist and would need to be diagnosed by a lactation consultant.

Solution: It’s best to discuss treatment options with either your pediatrician or an IBCLC (International Board Certified Lactation Consultant) Some options include tongue/ lip tie revision which is when a doctor snips the tight frenulum. There is not usually anesthetic needed and is done in office in about 1-2 seconds! The mother often notices a difference in breastfeeding immediately but can possibly take 2-3 weeks to make a full change.

Starting off Great!

Below you can use see some tips and tricks to getting off to a great start on your breastfeeding journey:

  1. Nurse immediately following birth
  2. Nursing frequently will increase your milk supply and immediately begin the bonding process!
  3. You CAN’T nurse too often, you CAN nurse too little
  4. Nurse at the first signs of hunger (stirring, rooting with their mouth)
  5. Nurse at least every two hours during the day and every four hours at night
  6. Watch the baby not the clock!

 

Breastfeeding Benefits

Breastmilk is the absolute perfect food, and it gives your baby the healthy start that will last a lifetime!

Some benefits of breastfeeding include:

  1. It’s easier for your baby to digest.
  2. It doesn’t need to be prepared.
  3. It’s always available.
  4. It has all the nutrients, calories, and fluids your baby needs to be healthy.
  5. It has growth factors that ensure the best development of your baby’s organs.
  6. Studies have shown that breastfeeding may help to protect against obesity, diabetes, sudden infant death syndrome (SIDS), asthma, eczema, colitis, and some types of cancers.

Some risks when not breastfeeding or mothers milk is not available:

  1. Reduced immunity to disease if mother’s milk is not used (pumping helps reduce this concern)
  2. Increased risk of juvenile type diabetes, allergies GI problems, certain cancers
  3. Increased risk of heart disease and obesity as adult
  4. Orthodontic problems & facial development
  5. Increased risk of dental decay
  6. Spinal development abnormalities
  7. Facial development abnormalities
  8. Speech defects
  9. Increased risk of SIDS

 

So when women say that they can’t breastfeed with the excuses of “I don’t have enough milk” you really need to know more to evaluate if that’s the actual problem. As far as the other reasons “breastfeeding imposes too many demands on me, breastmilk isn’t as good as formula” the latter is explained in Breastfeeding Part 1 and Part 2. The former, well in the beginning of their breastfeeding relationship it may be difficult because neither has done it before. If breastfeeding is worked on and all difficulties surpassed then it should be easier and more timely than other forms of feeding. You don’t have to prepare anything (i.e. bottles) or worry about being away from home unprepared. Though when your baby is young and feeding often you won’t be able to leave them alone for extended periods of time unless you’re pumping which is a whole nother topic for discussion.

All in all you need to make the decision and not let me or others make it for you. My whole goal of this article is to unveil a few of the common reasons why mothers don’t breastfeed that have been placed in their heads by a culture run by consumerism and marketing.

Hope You Enjoyed!

Megan

 

 

 

 

 

 

One thought on “What are Boobs?

Add yours

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Create a website or blog at WordPress.com

Up ↑

%d bloggers like this: