Relationship of Physiology and Proper Breastfeeding - Research Paper Example

?Relationship of Physiology and Proper Breastfeeding The promotion of breastfeeding paves way to understanding the physiological mechanisms behind it. Knowledge on how breastfeeding works corrects misconceptions and eases anxieties of the mother towards the practice. Understanding the process of lactation from milk production to extraction allows the mother to formulate strategies on how to effectively carry out the practice. Basically, a mother has to familiarize herself with her breast. From the outside, an erectile muscle, known as the nipple, serves as the passage of milk (Vinther & Helsing, 1997). Behind each nipple are the lactiferous sinuses which serve as the reservoir for the collected milk (Vinther & Helsing, 1997). This anatomy explains why the proper way of breastfeeding entails that the baby’s mouth should not only cover the nipple but the areola as well. The milk is contained in the lactiferous sinuses and not in the nipples; thus, if the baby only sucks on the nipple, it will not be able to get all the available milk in the breast. Further, the lactiferous sinuses receive the milk coming from the lactiferous ducts, which in turn, serve as passageways of milk produced in the tubule-alveolar glands clustered at the end of each duct (Vinther & Helsing, 1997). Moreover, the glands will only produce milk when stimulated by prolactin produced in the anterior pituitary gland (Vinther & Helsing, 1997). Even before the baby is born, the hypothalamus is already primed to send signals to the pituitary gland to produce prolactin; therefore, synthesis of breast milk starts even before giving birth. After birth, the sucking of the baby stimulates the sensory receptors in the nipple, which then send signals to the hypothalamus, leading to the synthesis and release of prolactin from the anterior pituitary gland (Vinther & Helsing, 1997). Simultaneously, the hypothalamus will also synthesize oxytocin which will be stored in and released from the posterior pituitary glands (Vinther & Helsing, 1997). In turn, oxytocin stimulates the myoepithelial cells within the areola to contract and squeeze milk out from the lactiferous sinuses into the nipples (Vinther & Helsing, 1997). This process is termed as ejection reflex (Vinther & Helsing, 1997). Hence, the secretion of milk is proportional to the stimulation of the nipple by sucking. As mentioned earlier, it is important that the baby’s mouth also covers the areola; otherwise, the baby will not only fail to extract all the available milk but the breast will also be engorged due to continuous stimulation of the nipple leading to production of more prolactin and oxytocin. Benefits of Breastfeeding Infants are very vulnerable to diseases; hence, anything taken by them can put so much health risks including inadequacy of nutrients, infection, allergy and gastrointestinal disturbances. However, breast milk being is naturally formulated to avoid all these risks and to render numerous benefits in the initial growing years of the child. Nonetheless, aside from these benefits, breast milk also offers convenience as it is always at proper temperature and is always available without the need for preparation (Kliegman et al., 2007). In terms of nutrition, breast milk contains high levels of fats, lactose and Vitamin A. Fats are mainly polyunsaturated fatty acids which are readily absorbed due to the presence of bile salt stimulated lipase in breast milk milk (Kliegman et al., 2007).. Because of the presence of this enzyme, there is no loss of fats in stools. Moreover, the predominant protein in breast milk is whey, which consists of alpha-lactaglobulin, lactoferrin and IgA. Alpha-lactoglubulin which cannot be found in formula milk reduces the frequency of allergies (Kliegman et al., 2007). Lactoferrin, also found in whey, binds to iron, increasing its absorption. This compensates for the fact that breast milk actually has lower contents of iron but then again because of this protein, its iron is more absorbed compared to other kinds of milk (Kliegman et al., 2007). Among the advantages of breastfeeding, perhaps, the most important is the anti-infective properties that it confers. Aside from being free from bacteria itself, its high IgA content gives protection against pathogens that contribute to morbidity milk (Kliegman et al., 2007). Basically, it provides mucosal barrier in order to prevent harmful microorganisms to adhere to the intestine, resulting to less frequency of gastrointestinal disturbances (Kliegman et al., 2007). More importantly, IgA also serves as antibodies to viruses that the mother has been exposed to. This is because the viral antigen ingested by the mother during pregnancy will be presented by the intestinal macrophages called, Peyer’s Patches to the lymph nodes, which will then produce antibodies in the form of IgA against the pathogen (Kliegman et al., 2007). These antibodies will go circulate in the blood until it reaches the mammary circulation (Kliegman et al., 2007). Consequently, when the baby feeds on the mother’s milk, these antibodies will also be transmitted to the gastrointestinal tract then to the circulation; thus providing protection (Kliegman et al., 2007). In addition, the composition of breast milk also provides defense against specific bacteria. For example, aside from binding to iron, lactoferrin also inhibit the growth of E. coli in the intestine (Kliegman et al., 2007). Also, the bile salt stimulated lipase is effective in killing E. histolytica and G. lamblia (Kliegman et al., 2007). Furthermore, breastfeeding is also advantageous is enhancing the maternal bond between mother and child. Breastfeeding makes the mother involved in directly nurturing the baby; thus, promoting feelings of accomplishment and being needed (Kliegman et al., 2007). As the baby becomes familiar with the scent of the mother’s breast, it begins to long for the mother, developing an intimate and secured physical relationship with her (Kliegman et al., 2007). Challenges to Breastfeeding Despite the documented benefits that can be derived from breastfeeding, some mothers remain reluctant to put it into practice. The most common problem associated with breastfeeding is the lack of confidence of the mother in their capability to produce adequate milk (Vinther & Helsing, 1997). While inability to produce milk indeed happens, it is very rare (Vinther & Helsing, 1997). Most often, this problem is mainly due to improper breastfeeding. As mentioned earlier, it is important that the baby’s mouth covers the areola so it can squeeze out the lactiferous sinuses that contain milk. However, if the baby is not properly latched on in the mother’s breast, it would not be able to extract enough milk (Vinther & Helsing, 1997). Moreover, it is noteworthy that oxytocin, as discussed previously, is very important in milk ejection. However, certain factors may contribute to the inhibition of oxytocin. Psychological factors such as pain, fear, shock, stress or embarrassment result to increased levels of norepinephrine and epinephrine in the blood, which will cause constriction of peripheral blood vessels (Vinther & Helsing, 1997). When this happens, less amounts of oxytocin will reach the myoepithelial cells, leading to decreased milk ejection (Vinther & Helsing, 1997). Because the baby gets insufficient milk, it may cry, contributing to further stress in the part of the mother. As a result, oxytocin is further inhibited and the vicious cycle continues. Furthermore, many mothers usually respond to problems with breastfeeding by introducing bottle feeding. This becomes disadvantageous because it lessens the work of the baby’s developing mouth; thus, upon re-exposure to the mother’s breast, the baby can no longer suck as efficiently as before and milk supply from the breast is further compromised (Vinther & Helsing, 1997). While inadequacy of milk is a common issue, overproduction is also one of the pressing reasons that challenge breastfeeding. However, this can also be attributed to poor breastfeeding practices. Again, if the baby’s mouth only covers the nipple, it continues to stimulate the production of milk without necessarily extracting it out from the lactiferous sinuses. As a result, the breasts feel engorged (Vinther & Helsing, 1997). In addition, another reason for engorgement is removing the baby from the breast too soon (Vinther & Helsing, 1997). Further, it is important to note that when the baby sucks a nipple, the other breast is also stimulated to secrete milk simultaneously. Since milk may accumulate in the other breast while the baby is feeding from the other (Vinther & Helsing, 1997), it is important to do alternate breastfeeding on the right and left breasts after a period of time. Meanwhile, the most superficial yet another common hindrance to breastfeeding is the misconception that the mother might lose the shape of the breast. This is not true because based on anatomy, the breasts are held in place by the Cooper’s ligament. This ligament becomes lax with age; hence, the shape of the breast depends on the age of the mother and not on breastfeeding per se. Breastfeeding Interventions & Practices In response to the challenges in breastfeeding, several intervention programs have been formulated by different countries and even by international organizations. It is believed that the practice of breastfeeding should be enhanced right after the birth of the child. This is made possible by the Baby Friendly Hospital Initiative program introduced by the World Health Organization. Part of this program includes not giving newborns artificial nipples, food or drink aside from the mother’s milk (Shealy, Li & Benton-Davis. 2005). This entails that the baby should be roomed in with the mother unlike in traditional practice where the baby stays in the nursery (Shealy, Li & Benton-Davis. 2005). But then again, certain exceptions apply such as medical conditions contraindicating the practice of breastfeeding. Moreover, legislations have also been passed, favoring support of breastfeeding in the workplace (Shealy, Li & Benton-Davis. 2005). This is due to the fact that mothers usually return to work three months after giving birth, resulting to shorter duration of breastfeeding (Shealy, Li & Benton-Davis. 2005). While mothers can pump milk in the workplace, facilities are not enough to accommodate this practice. In response to this, the establishment of Nursing Mother Room in the workplace has been prescribed by several laws (Shealy, Li & Benton-Davis. 2005). This facility provides privacy and equipments such as refrigerator, sink, seating and electrical source for the convenience of breastfeeding employees to extract their milk and store it for the use of their babies (Shealy, Li & Benton-Davis. 2005). Lastly, the most important intervention to promote breastfeeding is proper education of the mothers. This is geared not only to increase knowledge and skills but also to enhance the mothers’ attitudes and feelings towards breastfeeding. Moreover, both prenatal and intrapartum education are essential in carrying out this intervention successfully (Shealy, Li & Benton-Davis. 2005). In the prenatal period, there are professionals who conduct formal classes using videos and demonstrations in hospitals for pregnant mothers (Shealy, Li & Benton-Davis. 2005). Misconceptions are straightened out and important practices and proper positioning are emphasized. In the intrapartum education, the same kind of lessons is offered; however, in contrast to prenatal education, classes are less formal since it is during this time that time is extremely crucial (Shealy, Li & Benton-Davis. 2005). References Kliegman, R., Behrman, R., Jenson, H. & Stanton, B. (2007). Nelson textbook of Pediatrics. Philadelphia: Saunders Elsevier. Shealy, K., Li, R., Benton-Davis, S. (2005). The CDC guide to breastfeeding interventions. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention. Vinther, T. & Helsing, E. (1997). Breastfeeding: How to support success. Copenhagen: World Health Organization, Regional Office for Europe. Read More