Breast milk (sometimes spelled as breastmilk ) or mother's milk is milk produced by the mammary glands in the breast of female humans. Breast milk is the primary source of nutrition for newborn infants , comprising fats, proteins, carbohydrates, and a varying composition of minerals and vitamins. Breast milk also contains substances that help protect an infant against infection and inflammation, such as symbiotic bacteria and other microorganisms and immunoglobulin A , whilst also contributing to the healthy development of the infant's immune system and gut microbiome .
167-591: Breastfeeding , also known as nursing , is the process where breast milk is fed to a child. Breast milk may be from the breast, or may be pumped and fed to the infant. The World Health Organization (WHO) recommend that breastfeeding begin within the first hour of a baby's birth and continue as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D , are typically given. The WHO recommends exclusive breastfeeding for
334-525: A 73% decreased risk of sudden infant death syndrome , increased intelligence , decreased likelihood of contracting middle ear infections , cold and flu resistance, a tiny decrease in the risk of childhood leukemia , lower risk of childhood onset diabetes , decreased risk of asthma and eczema , decreased dental problems , decreased risk of obesity later in life, and a decreased risk of developing psychological disorders , including in adopted children. In addition, feeding an infant breast milk
501-432: A band of tissue, known as the frenulum , attaches the tongue to the base of the mouth, restricting the tongue's vertical movement and preventing the infant from pressing the breast and nipple into the soft palate . A posterior tongue-tie is a band of tissue that can only be felt on exam, and tends to impact breastfeeding less severely than its anterior counterpart. If it is determined that the inability to latch on properly
668-404: A certain probability of occurring within the limits of the estimated due date. A study of singleton live births came to the result that childbirth has a standard deviation of 14 days when gestational age is estimated by first trimester ultrasound , and 16 days when estimated directly by last menstrual period. Fertility and fecundity are the respective capacities to fertilize and establish
835-405: A clinical pregnancy and have a live birth. Infertility is an impaired ability to establish a clinical pregnancy and sterility is the permanent inability to establish a clinical pregnancy. The capacity for pregnancy depends on the reproductive system , its development and its variation , as well as on the condition of a person. Women as well as intersex and transgender people who have
1002-406: A delay in their milk coming in should consult with a lactation specialist and their pediatrician, as they may need to supplement with donor milk or formula to help the infant gain weight and pump to encourage milk to come in sooner and in greater volume. Breast milk supply augments in response to the baby's demand for milk, and decreases when milk is allowed to remain in the breasts. When considering
1169-558: A distinct functionality. The breast milk of diabetic mothers has been shown to have a different composition from that of non-diabetic mothers. It may contain elevated levels of glucose and insulin and decreased polyunsaturated fatty acids. A dose-dependent effect of diabetic breast milk on increasing language delays in infants has also been noted, although doctors recommend that diabetic mothers breastfeed despite this potential risk. Women breastfeeding should consult with their physician regarding substances that can be unwittingly passed to
1336-520: A feeling of energy and satiety. The lower risk of child-onset diabetes may be more applicable to infants who were born from diabetic mothers. The reason is that while breastfeeding for at least the first six months of life minimizes the risk of type 1 diabetes from occurring in the infant, inadequate breastfeeding in an infant prenatally exposed to diabetes was associated with a higher risk of the child developing diabetes later. There are arguments that breastfeeding may contribute to protective effects against
1503-404: A functioning female reproductive system are capable of pregnancy. In some cases, someone might be able to produce fertilizable eggs, but might not have a womb or none that can sufficiently gestate, in which case they might find surrogacy . Through an interplay of hormones that includes follicle stimulating hormone that stimulates folliculogenesis and oogenesis creates a mature egg cell ,
1670-485: A higher caloric intake than breastfed babies. Breast milk is not sterile and has its own microbiome , but contains as many as 600 different species of various bacteria , including beneficial Bifidobacterium breve , B. adolescentis , B. longum , B. bifidum , and B. dentium , which contribute to colonization of the infant gut. As a result, it can be defined as a probiotic food, depending on how one defines " probiotic ". Breast milk also contains
1837-504: A mild laxative effect, expelling meconium and helping to prevent the build-up of bilirubin (a contributory factor in jaundice ). Male lactation can occur; the production or administration of the hormone prolactin is necessary to induce lactation (see male lactation ). Actual inability to produce enough milk is rare, with studies showing that mothers from malnourished regions still produce amounts of milk of similar quality to that of mothers in developed countries. There are many reasons
SECTION 10
#17327806013892004-405: A mother may not produce enough breast milk . Some of the most common reasons are an improper latch (i.e., the baby does not connect efficiently with the nipple), not nursing or pumping enough to meet supply, certain medications (including estrogen-containing hormonal contraceptives ), illness, and dehydration. A rarer reason is Sheehan's syndrome , also known as postpartum hypopituitarism , which
2171-476: A naturally warm environment that helps them regulate their temperature. It is also beneficial to the mother, as it may improve the development of her milk supply and be beneficial for her mental health. Newborn babies usually breastfeed 8 to 12 times every 24 hours, and they typically express hunger cues every one to three hours for the first two to four weeks of their lives. A newborn has a small stomach capacity, approximately 20 ml. The amount of breast milk that
2338-619: A number of benefits to both mother and baby that infant formula lacks. Increased breastfeeding to near-universal levels in low and medium income countries could prevent approximately 820,000 deaths of children under the age of five annually. Breastfeeding decreases the risk of respiratory tract infections , ear infections , sudden infant death syndrome (SIDS) , and diarrhea for the baby, both in developing and developed countries . Other benefits have been proposed to include lower risks of asthma , food allergies , and diabetes . Breastfeeding may also improve cognitive development and decrease
2505-473: A number of factors as described in the Process "Delay in milk 'coming in'" subsection below. Oxytocin , which signals the smooth muscle of the uterus to contract during pregnancy, labor, birth and following delivery, is also involved in the process of breastfeeding. Oxytocin also contracts the smooth muscle layer of band-like cells surrounding the milk ducts and alveoli to s the newly produced milk through
2672-586: A pacifier beginning at birth or after lactation was established did not significantly affect the duration of exclusive and partial breastfeeding up to four months of age. The CDC, however, currently (2022) reports that early use of pacifiers can have a negative outcome on the success of breastfeeding and they suggest that it should be delayed until breastfeeding is firmly established. Ankyloglossia, also called "tongue-tie" may cause shallow latch, poor milk transfer, and other problems with breastfeeding. There are two types of tongue-ties; an anterior tongue-tie occurs when
2839-399: A poor, shallow latch, the infant latches close to or at the nipple, causing the mother intense pain during latching that is relieved with infant release from the breast. While the infant is at the breast, the first indicators of a shallow latch are having the areola be largely visible outside the infant's mouth and a narrow infant mouth angle. Additional signs result from poor positioning when
3006-531: A possibly low milk supply, it is important to consider the difference between "perceived low milk supply" and "true low milk supply". Perceived low milk supply occurs when mothers, for a variety of reasons, believe that they are not making enough milk to feed their infant. These reasons may include fussiness, colic , preference for the bottle as opposed to the breast, long nursing duration, decreased sensation of breast fulness, and even decreased frequency of infant stools. However, in these cases, it important to reassure
3173-415: A pregnancy 12 to 15 days after fertilization. A quantitative blood test can determine approximately the date the embryo was fertilized because hCG levels double every 36 to 72 hours before 8 weeks' gestation. A single test of progesterone levels can also help determine how likely a fetus will survive in those with a threatened miscarriage (bleeding in early pregnancy), but only if the ultrasound result
3340-400: A pregnancy to a viable stage . Twins and other multiple births are counted as one pregnancy and birth. A woman who has never been pregnant is referred to as a nulligravida. A woman who is (or has been only) pregnant for the first time is referred to as a primigravida , and a woman in subsequent pregnancies as a multigravida or as multiparous. Therefore, during a second pregnancy
3507-412: A pregnancy; however, they are usually not felt until the second or third trimester. Final weight gain takes place during the third trimester; this is the most weight gain throughout the pregnancy. The woman's abdomen will transform in shape as the fetus turns in a downward position ready for birth. The woman's navel will sometimes become convex, "popping" out, due to the expanding abdomen . The uterus,
SECTION 20
#17327806013893674-492: A process which leads to a first breastfeed. Shortly after birth, the infant relaxes and makes small movements of the arms, shoulders and head. If placed on the mother's abdomen the baby gradually inches towards the breast, called the breast crawl and begins to feed. After feeding, it is normal for a baby to remain latched to the breast while resting. This is sometimes mistaken for lack of appetite. Absent interruptions, all babies follow this process. Rushing, by picking up and moving
3841-629: A restaurant in New York City, have used human breast milk, or at least advocated its use, as a substitute for cow's milk in dairy products and food recipes . An Icecreamist in London's Covent Garden started selling an ice cream named Baby Gaga in February 2011. Each serving cost £14. All the milk was donated by a Mrs Hiley who earned £15 for every 10 ounces and called it a "great recession beater". The ice cream sold out on its first day. Despite
4008-502: A rule, the milk of mammals that nurse frequently (including human babies) is less rich, or more watery, than the milk of mammals whose young nurse less often. Human milk is noticeably thinner and sweeter than cow's milk. Whole cow's milk contains too little iron , retinol , vitamin E , vitamin C , vitamin D , unsaturated fats or essential fatty acids for human babies. Whole cow's milk also contains too much protein , sodium , potassium , phosphorus and chloride which may put
4175-458: A signal of the infant tired or becoming relaxed with a slower milk velocity. Numerous health organizations, including, but not limited to, the CDC, WHO, National Health Service, Canadian Pediatric Society, American Academy of Pediatrics, and American Academy of Family Physicians, recommend breastfeeding exclusively for six months following birth, unless medically contraindicated. Exclusive breastfeeding
4342-400: A significant risk of serious birth defects, but consuming alcohol after the birth of the infant is considered safe. High caffeine intake by breastfeeding mothers may cause their infants to become irritable or have trouble sleeping. A meta-analysis has shown that breastfeeding mothers who smoke expose their infants to nicotine, which may cause respiratory illnesses, including otitis media in
4509-538: A small proportion of these cross over the nursing infant's intestinal tract into the bloodstream to reach certain organs and transform into fully functional cells. Because of its diverse population of cells and multifarious functions, researchers have argued that breast milk should be considered a living tissue. Breast milk contains a unique type of sugars, human milk oligosaccharides (HMOs), which were not present in traditional infant formula, however they are increasing added by many manufacturers. HMOs are not digested by
4676-430: A strain on an infant's immature kidneys . In addition, the proteins, fats and calcium in whole cow's milk are more difficult for an infant to digest and absorb than the ones in breast milk. The composition of marsupial and monotreme milk contains essential nutrients, growth factors and immunological properties to support the development of joeys and puggles. * Note: Milk is generally fortified with vitamin D in
4843-468: A thin yellowish fluid that is the same fluid that sometimes leaks from the breasts during pregnancy. It is rich in protein and antibodies that provide passive immunity to the baby (the baby's immune system is not fully developed at birth). Colostrum also helps the newborn's digestive system to grow and function properly. Colostrum will gradually change to become mature milk. In the first 3–4 days it will appear thin and watery and will taste very sweet; later,
5010-401: A variety of somatic cells and stem cells and the proportion of each cell type differs from individual to individual. The somatic cells are mainly lactocytes and myoepithelial cells derived from the mother's mammary glands. The stem cells found in human breast milk have been shown to be able to differentiate into a variety of other cells involved in the production of bodily tissues and
5177-484: A woman should consider the possibility that a blocked milk duct or infection may be present and seek medical intervention. Although very common, nipple pain and nipple trauma (cracking, open sores) should not be normalized, as these are often signs of a shallow latch or other underlying problem that can be evaluated and fixed . In addition to shallow latch, other causes of nipple pain include, but are not limited to, skin infection or inflammation , blood vessel spasm or
Breastfeeding - Misplaced Pages Continue
5344-460: A woman undergoes many normal physiological changes, including behavioral , cardiovascular , hematologic , metabolic , renal , and respiratory changes. Increases in blood sugar , breathing , and cardiac output are all required. Levels of progesterone and estrogens rise continually throughout pregnancy, suppressing the hypothalamic axis and therefore the menstrual cycle . A full-term pregnancy at an early age (less than 25 years) reduces
5511-913: A woman would be described as gravida 2, para 1 and upon live delivery as gravida 2, para 2. In-progress pregnancies, abortions , miscarriages and/or stillbirths account for parity values being less than the gravida number. Women who have never carried a pregnancy more than 20 weeks are referred to as nulliparous . A pregnancy is considered term at 37 weeks of gestation. It is preterm if less than 37 weeks and postterm at or beyond 42 weeks of gestation. American College of Obstetricians and Gynecologists have recommended further division with early term 37 weeks up to 39 weeks, full term 39 weeks up to 41 weeks, and late term 41 weeks up to 42 weeks. The terms preterm and postterm have largely replaced earlier terms of premature and postmature . Preterm and postterm are defined above, whereas premature and postmature have historical meaning and relate more to
5678-580: Is a standard way of calculating the due date for a pregnancy when assuming a gestational age of 280 days at childbirth. The rule estimates the expected date of delivery (EDD) by adding a year, subtracting three months, and adding seven days to the origin of gestational age. Alternatively there are mobile apps , which essentially always give consistent estimations compared to each other and correct for leap year , while pregnancy wheels made of paper can differ from each other by 7 days and generally do not correct for leap year. Furthermore, actual childbirth has only
5845-579: Is a viable option. In the absence of pasteurized donor milk, commercial formula milk is recommended as a secondary alternative. However, unpasteurized breast milk from a source other than the infant's mother, particularly when shared informally, carries the risk of vertically transmitting bacteria, viruses (such as HIV ), and other microorganisms from the donor to the infant, rendering it an unsafe alternative. Breastfeeding offers health benefits to mother and child even after infancy. These benefits include proper heat production and adipose tissue development,
6012-431: Is about 54 Calories/100mL. The second type of milk is transitional milk, which is produced during the transition from colostrum to mature breast milk. As the breast milk matures over the course to several weeks, the protein content of the milk decreases on average. The caloric content of breastmilk is reflective of the caloric requirements of the infant, increasing steadily after 12 months. The caloric content of breastmilk in
6179-512: Is advantageous for adults, according to several 2015 news sources, breast milk is being used by bodybuilders for its nutritional value. In a February 2015 ABC News article, one former competitive body builder said, "It isn't common, but I've known people who have done this. It's certainly talked about quite a bit on the bodybuilding forums on the Internet." Calling bodybuilders "a strange breed of individuals", he said, "Even if this type of thing
6346-399: Is associated with lower insulin levels and higher leptin levels compared feeding an infant via powdered-formula . Many of the infection-fighting and immune system related benefits are associated with human milk oligosaccharides . Breastfeeding also provides health benefits for the mother. It assists the uterus in returning to its pre-pregnancy size and reduces post-partum bleeding, through
6513-504: Is associated with prolactin deficiency and may require hormone replacement. The amount of milk produced depends on how often the mother is nursing and/or pumping : the more the mother nurses her baby or pumps, the more milk is produced. It is beneficial to nurse when the baby wants to nurse rather than on a schedule. A Cochrane review came to the conclusion that a greater volume of milk is expressed whilst listening to relaxing audio during breastfeeding, along with warming and massaging of
6680-474: Is at its highest. Around the middle of the second trimester, movement of the fetus may be felt. At 28 weeks, more than 90% of babies can survive outside of the uterus if provided with high-quality medical care , though babies born at this time will likely experience serious health complications such as heart and respiratory problems and long-term intellectual and developmental disabilities. Prenatal care improves pregnancy outcomes. Nutrition during pregnancy
6847-403: Is called "full term". Whenever possible, waiting for labor to begin on its own in this time period is best for the health of the mother and baby. The decision to perform an induction must be made after weighing the risks and benefits, but is safer after 39 weeks. Events after 42 weeks are considered postterm . When a pregnancy exceeds 42 weeks, the risk of complications for both the woman and
Breastfeeding - Misplaced Pages Continue
7014-612: Is completely unsupported by research, they're prone to gym lore and willing to give it a shot if there is any potential effect." At the time the article was written, in the U.S., the price of breast milk procured from milk banks that pasteurize the milk, and have expensive quality and safety controls, was about $ 10 per US fluid ounce ($ 0.34/ml), and the price in the alternative market online, bought directly from mothers, ranges from $ 1–$ 4 per US fluid ounce ($ 0.03–$ 0.14/ml), compared to cow's milk at about $ 3.44 per US gallon ($ 0.0269/US fl oz; $ 0.0009/ml). Pregnancy Pregnancy
7181-505: Is defined as "an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk and no foods) except for vitamins, minerals and medications." Supplementation with human donor breastmilk may be indicated in some specific cases, as discussed below. After solids are introduced at around six months of age, continued breastfeeding is recommended. The American Academy of Pediatrics recommends that babies be breastfed at least until 12 months, or longer if both
7348-656: Is desired. Indications for use of donor breastmilk are very closely outlined by the American Academy of Pediatrics (AAP). Due to low availability and high cost of donor breastmilk, the AAP recommends prioritizing the use of the milk for infants born with a weight of less than 1500g (approximately 3lb 5oz), as it is helpful in decreasing rates of the severe intestinal infection, necrotizing enterocolitis , in this population. Effective positioning and technique for latching on are necessary to prevent nipple soreness and allow
7515-406: Is divided into three trimesters of approximately three months each. The first trimester includes conception, which is when the sperm fertilizes the egg. The fertilized egg then travels down the fallopian tube and attaches to the inside of the uterus , where it begins to form the embryo and placenta . During the first trimester, the possibility of miscarriage (natural death of embryo or fetus)
7682-414: Is especially beneficial for preterm babies who may initially lack the ability to suck effectively. Using cups to feed expressed breast milk and other supplements results in improved breastfeeding outcomes in terms of both duration and extent, compared with traditional bottle and tube feeding. For mothers unable to produce an adequate supply of breast milk, the use of pasteurized donor human breast milk
7849-410: Is helpful to have an electric, high-grade pump so that all of the milk ducts are stimulated. Galactagogues increase milk supply, although even herbal variants carry risks. Non-pharmaceutical methods should be tried first, such as pumping out the mother's breast milk supply often, warming or massaging the breast, as well as starting milk pumping earlier after the child is born if they cannot drink milk at
8016-401: Is important to ensure healthy growth of the fetus. Prenatal care may also include avoiding recreational drugs (including tobacco and alcohol ), taking regular exercise, having blood tests , and regular physical examinations . Complications of pregnancy may include disorders of high blood pressure , gestational diabetes , iron-deficiency anemia , and severe nausea and vomiting . In
8183-404: Is important to have the mother-infant dyad evaluated by a breastfeeding specialist or pediatrician to determine the true cause of the symptoms and determine the need for supplementation. Often, these symptoms are caused by poor milk transfer at the breast, and can be solved with adjustments to the latch, but occasionally they may be caused by other processes, unrelated to breastfeeding, so evaluation
8350-438: Is known as a blastocyst . The blastocyst arrives at the uterus and attaches to the uterine wall, a process known as implantation . The development of the mass of cells that will become the infant is called embryogenesis during the first approximately ten weeks of gestation. During this time, cells begin to differentiate into the various body systems. The basic outlines of the organ, body, and nervous systems are established. By
8517-415: Is less expensive than infant formula, but its impact on mothers' ability to earn an income is not usually factored into calculations comparing the two feeding methods. It is also common for women to experience generally manageable symptoms such as; vaginal dryness, De Quervain syndrome , cramping, mastitis , moderate to severe nipple pain and a general lack of bodily autonomy. These symptoms generally peak at
SECTION 50
#17327806013898684-528: Is necessary. Supplementation with formula is associated with decreased rates of exclusive breastfeeding at 6 months, and overall decreased length of breastfeeding. In terms of what to supplement with, the first choice is always the mother's own breastmilk, save any medical contraindications to its use. The second best option for supplementation is pasteurized human donor milk . Finally, specific formulas may be used for supplementation if maternal or donor breastmilk are not options. One situation where this may be
8851-405: Is no commercial formula that can adequately substitute for breast milk. In addition to the appropriate amounts of carbohydrate , protein , and fat , breast milk provides vitamins , minerals , digestive enzymes , and hormones . Breast milk also contains antibodies and lymphocytes from the mother that may help the baby resist infections. The immune function of breast milk is individualized, as
9018-464: Is not possible, expressing or pumping to empty the breasts can help mothers avoid plugged milk ducts and breast infection , maintain their milk supply, resolve engorgement , and provide milk to be fed to their infant at a later time. Medical conditions that do not allow breastfeeding are rare. Mothers who take certain recreational drugs should not breastfeed, however, most medications are compatible with breastfeeding. Current evidence indicates that it
9185-424: Is not produced or distributed industrially or commercially, because the use of human breast milk as an adult food is considered unusual to the majority of cultures around the world, and most disapprove of such a practice. In Costa Rica, there have been trials to produce human cheese , and custard from human milk, as an alternative to weaning . While there is no scientific evidence that shows that breast milk
9352-466: Is not recommended unless required for other medical reasons. Associated terms for pregnancy are gravid and parous . Gravidus and gravid come from the Latin word meaning "heavy" and a pregnant female is sometimes referred to as a gravida . Gravidity refers to the number of times that a female has been pregnant. Similarly, the term parity is used for the number of times that a female carries
9519-410: Is primitive neural activity rather than the beginning of conscious brain activity. Synapses do not begin to form until week 17. Neural connections between the sensory cortex and thalamus develop as early as 24 weeks' gestational age, but the first evidence of their function does not occur until around 30 weeks, when minimal consciousness , dreaming , and the ability to feel pain emerges. Although
9686-435: Is produced is timed to meet the infant's needs in that the first milk, colostrum, is concentrated but produced in only very small amounts, gradually increasing in volume to meet the expanding size of the infant's stomach capacity. Many newborns will typically feed for 10 to 15 minutes on each breast, however feeds may last up to 45 minutes depending on infant wakefulness and efficiency. It is important for parents to recognize
9853-506: Is related to ankyloglossia, a simple surgical procedure to clip the frenulum can correct the condition. The Academy of Breastfeeding Medicine and the Australian Dental Association have raised concern over the growing trend of oral tie surgeries, due to evidence for benefit being low-quality, inconsistent, or unsupported. Engorgement is the swelling and stretching of the breast tissue due to accumulation of fluid in
10020-427: Is relatively consistent. Breastmilk is made from nutrients in the mother's bloodstream and bodily stores. It has an optimal balance of fat, sugar, water, and protein that is needed for a baby's age appropriate growth and development. That being said, a variety of factors can influence the nutritional makeup of breastmilk, including gestational age, age of infant, maternal age, maternal smoking, and nutritional needs of
10187-600: Is small, studies have also shown that feeding infants with breast milk of HIV-positive mothers can actually have a preventative effect against HIV transmission between the mother and child. This inhibitory effect against the infant contracting HIV is likely due to unspecified factors exclusively present in breast milk of HIV-positive mothers. Most women that do not breastfeed use infant formula , but breast milk donated by volunteers to human milk banks can be obtained by prescription in some countries. In addition, research has shown that women who rely on infant formula could minimize
SECTION 60
#173278060138910354-454: Is sometimes used as the initiation of pregnancy, with the derived age being termed fertilization age . Fertilization usually occurs about two weeks before the next expected menstrual period. A third point in time is also considered by some people to be the true beginning of a pregnancy: This is time of implantation, when the future fetus attaches to the lining of the uterus. This is about a week to ten days after fertilization. The sperm and
10521-510: Is still safe to use, and most babies will drink it. Scalding it will prevent rancid taste at the expense of antibodies. It should be stored with airtight seals. Some plastic bags are designed for storage periods of less than 72 hours. Others can be used for up to 12 months if frozen. This table describes safe storage time limits. All mammalian species produce milk, but the composition of milk for each species varies widely and other kinds of milk are often very different from human breast milk. As
10688-416: Is suddenly stopped a woman's breasts are likely to become engorged. Pumping small amounts to relieve discomfort helps to gradually train the breasts to produce less milk. There is presently no safe medication to prevent engorgement, but cold compresses and ibuprofen may help to relieve pain and swelling. Pain should go away with emptying of the breasts. If symptoms continue and comfort measures are not helpful
10855-470: Is supplemented with vitamin D for this reason. Under the influence of the hormones prolactin and oxytocin , women produce milk after childbirth to feed the baby . The initial milk produced is referred to as colostrum , which is high in the immunoglobulin IgA , which coats the gastrointestinal tract . This helps to protect the newborn until its own immune system is functioning properly. It also creates
11022-461: Is the connecting cord from the embryo or fetus to the placenta. After about ten weeks of gestational age—which is the same as eight weeks after conception—the embryo becomes known as a fetus . At the beginning of the fetal stage, the risk of miscarriage decreases sharply. At this stage, a fetus is about 30 mm (1.2 inches) in length, the heartbeat is seen via ultrasound, and the fetus makes involuntary motions. During continued fetal development,
11189-469: Is the time during which one or more offspring develops ( gestates ) inside a woman 's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins . Pregnancy usually occurs by sexual intercourse , but can also occur through assisted reproductive technology procedures. A pregnancy may end in a live birth , a miscarriage , an induced abortion , or a stillbirth . Childbirth typically occurs around 40 weeks from
11356-634: Is unavoidable. However, spontaneous birth after 37 weeks is considered term and is not associated with the same risks of a preterm birth. Planned birth before 39 weeks by caesarean section or labor induction , although "at term", results in an increased risk of complications. This is from factors including underdeveloped lungs of newborns , infection due to underdeveloped immune system, feeding problems due to underdeveloped brain, and jaundice from underdeveloped liver. Babies born between 39 and 41 weeks' gestation have better outcomes than babies born either before or after this range. This special time period
11523-435: Is unlikely that COVID-19 can be transmitted through breast milk. Smoking tobacco and consuming limited amounts of alcohol and/or coffee are not reasons to avoid breastfeeding. Breast development starts in puberty with the growth of ducts, fat cells , and connective tissue. The ultimate size of the breasts is determined by the number of fat cells. The size of the breast is not related to a mother's breastfeeding capability or
11690-417: Is well established, the volume and content of the milk produced is controlled locally. Although prolactin levels are higher on average among breastfeeding mothers, prolactin levels themselves do not correlate to milk volume. At this stage, production of milk is triggered by milk drainage from the breasts. The only way to maintain milk supply is to drain the breasts frequently. Infrequent or incomplete drainage of
11857-416: Is widely experienced as painful, some women do report painless labors, while others find that concentrating on the birth helps to quicken labor and lessen the sensations. Most births are successful vaginal births, but sometimes complications arise and a woman may undergo a cesarean section . During the time immediately after birth, both the mother and the baby are hormonally cued to bond, the mother through
12024-934: The Journal of the Royal Society of Medicine , in which they say that "health claims do not stand up clinically and that raw human milk purchased online poses many health risks." CBS found a study from the Center for Biobehavioral Health at Nationwide Children's Hospital in Columbus that "found that 11 out of 102 breast milk samples purchased online were actually blended with cow's milk ." The article also explains that milk purchased online may be improperly sanitized or stored, so it may contain food-borne illness and infectious diseases such as hepatitis and HIV . A minority of people, including restaurateurs Hans Lochen of Switzerland and Daniel Angerer of Austria , who operates
12191-688: The ACE-inhibitors enalapril and captopril , anti-depressants of the SSRI and SNRI classes, and medications for gastroesophageal reflux such as omeprazole and ranitidine . Conversely, there are medications that are known to be toxic to the baby and thus should not be used in breastfeeding mothers, such as chemotherapeutic agents which are cytotoxic like cyclosporine , immunosuppressants like methotrexate , amiodarone , or lithium . Furthermore, drugs of abuse , such as cocaine, amphetamines, heroin, and marijuana cause adverse effects on
12358-645: The NHS in the UK have no such recommendation. Breast milk contains less iron than formula, but the iron is more bioavailable as lactoferrin , which carries more safety for mothers and children than ferrous sulphate. Both the AAP and the NHS recommend vitamin D supplementation for breastfed infants. Vitamin D can be synthesised by the infant via exposure to sunlight; however, many infants are deficient due to being kept indoors or living in areas with insufficient sunlight. Formula
12525-523: The fertilization age , which is the age of the embryo since conception. The American Congress of Obstetricians and Gynecologists recommends the following methods to calculate gestational age: Pregnancy is divided into three trimesters, each lasting for approximately three months. The exact length of each trimester can vary between sources. Due date estimation basically follows two steps: The American College of Obstetricians and Gynecologists divides full term into three divisions: Naegele's rule
12692-420: The "golden hour" during the immediate postpartum period, assists in the mother–child bonding for both mother and baby, and is thought to encourage instinctual breastfeeding behavior in the infant. Newborns who are immediately placed on their mother's skin have a natural instinct to latch on to the breast and start nursing, typically within one hour of birth. Success with breastfeeding in this "golden hour" increases
12859-538: The U.S. and Canada. Non-fortified milk contains only 2 IU per 3.5 oz. Almost all medicines, or drugs, pass into breastmilk in small amounts by a concentration gradient . The amount of the drug bound by maternal plasma proteins , the size of the drug molecule, the pH and/or pKa of the drug, and the lipophilicity of the drug all determine whether and how much of the drug will pass into breastmilk. Medications that are mostly non-protein bound, low in molecular weight , and highly lipid-soluble are more likely to enter
13026-756: The United States, 22.4% of babies are breastfed for 12 months, the minimum amount of time advised by the American Academy of Pediatrics . In India , mothers commonly breastfeed for 2 to 3 years. Supplementation is defined as the use of additional milk or fluid products to feed an infant, in addition to breastmilk, during the first 6 months of life. The Academy of Breastfeeding Medicine recommends only supplementing when medically indicated, as opposed to mixing use of formula and breastmilk for reasons that are not necessarily medical indications. Some medical indications for supplementation include low blood sugar, dehydration, excessive weight loss or poor gain, and jaundice in
13193-440: The United States, 60% of the women used birth control to some extent during the month pregnancy began. The usual signs and symptoms of pregnancy do not significantly interfere with activities of daily living or pose a health-threat to the mother or baby. However, pregnancy complications can cause other more severe symptoms, such as those associated with anemia . Common signs and symptoms of pregnancy include: (from
13360-596: The baby from her breast for a short time until the flow becomes less forceful. Milk may also let-down unexpectedly when a mother hears her baby cry or even only thinks about the baby. Nursing pads may be made or purchased to absorb unexpected milk flows. Infants of mothers with inverted nipples can still achieve a good latch with perhaps a little extra effort. For some women, the nipple may easily become erect when stimulated. Other women may require modified breastfeeding techniques, and some may need extra devices, such as nipple shells, modified syringes, or breast pumps to expose
13527-545: The baby to foods that the mother has eaten and decrease the risk of diarrheal illness . Although the baby has received some antibodies ( IgG ) through the placenta, colostrum contains a substance which is new to the newborn, secretory immunoglobulin A (IgA). IgA works to attack germs in the mucous membranes of the throat, lungs, and intestines, which are most likely to come under attack from germs. Additionally, colostrum and mature breast milk contain many antioxidant and anti-inflammatory enzymes and proteins that decrease
13694-418: The baby to obtain enough milk. Babies can successfully latch on to the breast from multiple positions. Each baby may prefer a particular position. The "football" hold places the baby's legs next to the mother's side with the baby facing the mother. Using the "cradle" or "cross-body" hold, the mother supports the baby's head in the crook of her arm. The "cross-over" hold is similar to the cradle hold, except that
13861-437: The baby to open their mouth with a wide gape. One way to help the infant achieve a deep latch is to compress the breast tissue into a "U" or "hamburger shape," so that the infant can fit the breast tissue into their mouth. This is done by the mother placing her thumb and fingers in line with the infant's nose and mouth respectively and using this grip to compress the breast tissue. If the newborn seems to need help in latching on,
14028-495: The brain, namely estrogen , progesterone , prolactin , which gradually increase throughout the pregnancy, and result in the structural development of the alveolar (milk-producing) tissue and the production of colostrum . While prolactin is the predominant hormone in milk production, progesterone , which is at high levels during pregnancy, blocks the prolactin receptors in the breast, thus inhibiting milk from "coming in" during pregnancy. Many other physiologic changes occur under
14195-411: The breast milk in larger quantities. Some drugs have no effect on the baby and can be used whilst breastfeeding, while other medications may be dangerous and harmful to the infant. Some medications considered generally safe for use by a breastfeeding mother, with a doctor’s or pharmacist’s advice, include simple analgesics or pain killers such as paracetamol/acetaminophen , anti-hypertensives such as
14362-495: The breast prior to and during feeding. A greater volume of milk expressed can also be attributed to instances where the mother starts pumping milk sooner, even if the infant is unable to breastfeed. Sodium concentration is higher in hand-expressed milk, when compared with the use of manual and electric pumps, and fat content is higher when the breast has been massaged, in conjunction with listening to relaxing audio. This may be important for low birthweight infants. If pumping, it
14529-399: The breast. Breast milk contains fats, proteins, carbohydrates (including lactose and human milk oligosaccharides), and a varying composition of minerals and vitamins. The composition changes over a single feed as well as over the period of lactation. Changes are particularly pronounced in marsupials . During the first few days after delivery, the mother produces colostrum . This is
14696-474: The breasts) or both. Primary causes may manifest prior to or during pregnancy, during labor, and even after birth. Secondary causes are far more common than primary ones. One study found that 15% of healthy first-time mothers had low milk supply 2–3 weeks after birth, with secondary causes accounting for at least two-thirds of those cases. Breast milk The World Health Organization (WHO) and UNICEF recommend exclusive breastfeeding with breast milk for
14863-426: The breasts, decreases blood flow to the alveoli and signals the milk-producing cells to produce less milk. The content of breast milk should be discussed in two separate categories – the nutritional content and the bioactive content, that is the enzymes , proteins , antibodies , and signaling molecules that assist the infant in ways outside of nutrition. The pattern of intended nutrient content in breast milk
15030-477: The case is in cases of infant metabolic diseases, such as galactosemia . The Academy of Breastfeeding Medicine recommends that supplementation only be used when medically indicated and when overseen by a medical professional, such as a pediatrician or family physician, and after consultation with an IBCLC. Without sufficient breast stimulation, supplementation can reduce the mother's milk production, so pumping would be indicated in these cases if continued breastfeeding
15197-466: The chin will be close to the breast, and the forehead and nose should be far from the breast. Another sign of a good latch is the contour of the infant's cheeks; the cheeks should be rounded all the way to the edge of the mouth, rather than dimpled or creased at the edge of the mouth. This is a good indicator of effective suck mechanics. Additionally, in order to achieve a deep latch, the infant's mouth must be open wide, preferably wider than 140 degrees. In
15364-502: The conclusion that 74% of breast milk samples from providers found from websites were colonized with gram-negative bacteria or had more than 10,000 colony-forming units /mL of aerobic bacteria . Bacterial growth happens during transit. According to the FDA, bad bacteria in food at room temperature can double every 20 minutes. Human milk is considered to be healthier than cow's milk and infant formula when it comes to feeding an infant in
15531-453: The control of progesterone and estrogen. These changes include, but are not limited to, dilation of blood vessels, increased blood flow to the uterus, increased availability of glucose (which subsequently is passed through the placenta to the fetus), and increased skin pigmentation, which results in darkening of the nipples and areola , formation of the linea nigra , and onset of melasma of pregnancy . The third stage of labor describes
15698-420: The development of type 1 diabetes because the alternative of bottle-feeding may expose infants to unhygienic feeding conditions. Though it is almost universally prescribed, in some countries during the 1950s, the practice of breastfeeding went through a period where it was out of vogue and the use of infant formula was considered superior to breast milk. However, it is since universally recognized that there
15865-408: The difference between Nutritive and Non-Nutritive Sucking. Nutritive Sucking follows a slow, rhythmic pattern, with 1–2 sucks per swallow. Non-nutritive sucking is a faster-paced sucking pattern with few swallows. This swallow pattern is often observed at the beginning and/or the end of a feed. At the beginning of the feed, this pattern triggers milk letdown, while at the end of the feed, this may be
16032-412: The duct system and out through the nipple. This process is known as the milk ejection reflex , or let-down. Because of oxytocin's dual activity at the breast and the uterus, breastfeeding mothers may also experience uterine cramping at the time of breastfeeding, for the first several days to weeks. Prolactin and oxytocin are vital for establishing milk supply initially, however, once the milk supply
16199-426: The early body systems, and structures that were established in the embryonic stage continue to develop. Sex organs begin to appear during the third month of gestation. The fetus continues to grow in both weight and length, although the majority of the physical growth occurs in the last weeks of pregnancy. Electrical brain activity is first detected at the end of week 5 of gestation, but as in brain-dead patients, it
16366-407: The egg cell, which has been released from one of the female's two ovaries , unite in one of the two fallopian tubes . The fertilized egg, known as a zygote , then moves toward the uterus, a journey that can take up to a week to complete. Cell division begins approximately 24 to 36 hours after the female and male cells unite. Cell division continues at a rapid rate and the cells then develop into what
16533-434: The end of the embryonic stage, the beginnings of features such as fingers, eyes, mouth, and ears become visible. Also during this time, there is development of structures important to the support of the embryo, including the placenta and umbilical cord . The placenta connects the developing embryo to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. The umbilical cord
16700-450: The enlarged uterus may impede blood flow by compressing the vena cava when lying flat, a condition that can be relieved by lying on the left side. Childbirth, referred to as labor and delivery in the medical field, is the process whereby an infant is born. A woman is considered to be in labor when she begins experiencing regular uterine contractions, accompanied by changes of her cervix—primarily effacement and dilation. While childbirth
16867-680: The equivalent of Raynaud Syndrome in the breast, mastitis , plugged ducts, and nipple blebs . Pain caused by a problem deep in the breast may also present with nipple pain due to the paths of nerves in the breast. In addition to the serious nature of many of these causes, nipple pain is a common reason for a mother stopping breastfeeding, so it is important that mothers experiencing nipple pain be evaluated. While milk normally "comes in" by 3 days after birth, there are several reasons this may be delayed. Risk factors for this delay include maternal diabetes , stressful delivery, retained placenta , prolonged labor and birth by C-section . Mothers experiencing
17034-728: The fat content very gradually increases, with the milk becoming fattier and fattier over time. The level of Immunoglobulin A (IgA) in breast milk remains high from day 10 until at least 7.5 months post-partum. Human milk contains 0.8–0.9% protein, 4.5% fat, 7.1% carbohydrates, and 0.2% ash (minerals). Carbohydrates are mainly lactose ; several lactose-based oligosaccharides (also called human milk oligosaccharides ) have been identified as minor components. The fat fraction contains specific triglycerides of palmitic and oleic acid (O-P-O triglycerides), and also lipids with trans bonds (see: trans fat ). The lipids are vaccenic acid , and conjugated linoleic acid (CLA) accounting for up to 6% of
17201-645: The female gamete . Fertilization is the event where the egg cell fuses with the male gamete, spermatozoon . After the point of fertilization, the fused product of the female and male gamete is referred to as a zygote or fertilized egg. The fusion of female and male gametes usually occurs following the act of sexual intercourse . Pregnancy rates for sexual intercourse are highest during the menstrual cycle time from some 5 days before until 1 to 2 days after ovulation. Fertilization can also occur by assisted reproductive technology such as artificial insemination and in vitro fertilisation . Fertilization (conception)
17368-470: The fetus begins to move during the first trimester, it is not until the second trimester that movement, known as quickening , can be felt. This typically happens in the fourth month, more specifically in the 20th to 21st week, or by the 19th week if the woman has been pregnant before. It is common for some women not to feel the fetus move until much later. During the second trimester, when the body size changes, maternity clothes may be worn. During pregnancy,
17535-549: The fetus increases significantly. Therefore, in an otherwise uncomplicated pregnancy, obstetricians usually prefer to induce labor at some stage between 41 and 42 weeks. The postpartum period also referred to as the puerperium , is the postnatal period that begins immediately after delivery and extends for about six weeks. During this period, the mother's body begins the return to pre-pregnancy conditions that includes changes in hormone levels and uterus size. The beginning of pregnancy may be detected either based on symptoms by
17702-428: The fetus through the placenta, which is no longer needed, and supply additional fluid to the breasts in order to start the process of making milk. These fluid shifts often result in some of this excess fluid leaking into the breast tissue. Finally, milk "coming in" can create an uncomfortably full feeling, which combined with the aforementioned fluid accumulation in the breast tissue, can cause severe pain. If breastfeeding
17869-411: The first 12 months of breastfeeding is approximated to be 58-72 Calories/100mL. Comparatively, the caloric content after 48 months is approximately 83-129 Calories/100mL. When a mother has her full milk supply and is feeding her infant, the first milk to be expressed is called the foremilk. Foremilk is typically thinner and less rich in calories. The hindmilk that follows is rich in calories and fat. If
18036-412: The first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months, and 58% of mothers continue breastfeeding up to the age of two years and beyond. Breastfeeding has
18203-478: The first seven weeks following implantation (i.e. ten weeks' gestational age), after which the term fetus is used until birth. Signs and symptoms of early pregnancy may include missed periods , tender breasts, morning sickness (nausea and vomiting), hunger, implantation bleeding , and frequent urination. Pregnancy may be confirmed with a pregnancy test . Methods of birth control —or, more accurately, contraception —are used to avoid pregnancy. Pregnancy
18370-525: The first six months of an infant’s life. This period is followed by the incorporation of nutritionally adequate and safe complementary solid foods at six months, a stage when an infant’s nutrient and energy requirements start to surpass what breast milk alone can provide. Continuation of breastfeeding is recommended up to two years of age. This guidance is due to the protective benefits of breast milk, which include less infections such as diarrhea—a protection not afforded by formula milk . Breast milk constitutes
18537-479: The first six months of life, but only under extreme situations do international health organizations support feeding an infant breast milk from a healthy wet nurse rather than that of its biological mother. One reason is that the unregulated breast milk market is fraught with risks, such as drugs of abuse and prescription medications being present in donated breast milk. The transmission of these substances through breast milk can do more harm than good when it comes to
18704-566: The first trimester, minute ventilation increases by 40 percent. The womb will grow to the size of a lemon by eight weeks. Many symptoms and discomforts of pregnancy , such as nausea and tender breasts , appear in the first trimester. During the second trimester, most women feel more energized and put on weight as the symptoms of morning sickness subside. They begin to feel regular fetal movements , which can become strong and even disruptive. Braxton Hicks contractions are sporadic uterine contractions that may start around six weeks into
18871-542: The gap between the level of immunity protection and cognitive abilities a breastfed child benefits from versus the degree to which a bottle-fed child benefits from them. This can be done by supplementing formula-fed infants with bovine milk fat globule membranes (MFGM) meant to mimic the positive effects of the MFGMs which are present in human breast milk. Expressed breast milk can be stored . Lipase may cause thawed milk to taste soapy or rancid due to milk fat breakdown. It
19038-413: The health outcomes of the infant recipient. In the United States, the online marketplace for breast milk is largely unregulated and the high premium has encouraged food fraud . Human breast milk may be diluted with other liquids to increase volume including cow’s milk , soy milk , and water , thus undermining its health benefits. A 2015 CBS article cites an editorial led by Dr. Sarah Steele in
19205-471: The human milk fat. The principal proteins are alpha- lactalbumin , lactoferrin (apo-lactoferrin), IgA, lysozyme , and serum albumin . In an acidic environment such as the stomach , alpha-lactalbumin unfolds into a different form and binds oleic acid to form a complex called HAMLET that kills tumor cells. This is thought to contribute to the protection of breastfed babies against cancer. Non-protein nitrogen-containing compounds, making up 25% of
19372-496: The ideal childbirth, labor begins on its own "at term". Babies born before 37 weeks are " preterm " and at higher risk of health problems such as cerebral palsy . Babies born between weeks 37 and 39 are considered "early term" while those born between weeks 39 and 41 are considered "full term". Babies born between weeks 41 and 42 weeks are considered "late-term" while after 42 weeks they are considered " post-term ". Delivery before 39 weeks by labor induction or caesarean section
19539-403: The infant but help to make up the intestinal flora . They act as decoy receptors that block the attachment of disease causing pathogens , which may help to prevent infectious diseases. They also alter immune cell responses, which may benefit the infant. As of 2015 more than a hundred different HMOs have been identified; both the number and composition vary between women and each HMO may have
19706-433: The infant comes toward the breast to latch. If the infant leads with their brow or forehead, they are likely to flex their neck; this mechanism of latching causes the nipple to point down and then hit the hard palate during sucking. From an external view, this manifests as the nose and forehead being close to the breast and the chin far from the breast. This neck flexion also obstructs the normal swallowing mechanism, preventing
19873-454: The infant during breastfeeding. Adverse effects include seizures, tremors, restlessness, and diarrhea. To reduce infant exposure to medications used by the mother, use topical therapy or avoid taking the medication during breastfeeding times when possible. Hormonal products and combined oral contraceptives should be avoided during the early postpartum period as they can interfere with lactation. There are some medications that may stimulate
20040-407: The infant from drinking efficiently. In addition to not being able to swallow properly, this shallow latch prevents the infant from adequately compressing the glandular tissue behind the nipple and stimulating milk flow; thus, they may begin to apply more suction, which manifests externally as cheek dimpling, or sucking their cheeks in. When the baby suckles muscles in the breast squeeze milk towards
20207-1315: The infant to the breast, or interrupting the process, such as removing the baby to weigh him/her, may complicate subsequent feeding. Activities such as weighing, measuring, bathing, needle-sticks, and eye prophylaxis wait until after the first feeding. Children who are born preterm (before 37 weeks), children born in the early term period (37 weeks–38 weeks and 6 days), and children born with low muscular tone, such as those with chromosomal abnormalities like Down syndrome or neurological conditions like Cerebral palsy , may have difficulty in initiating breast feeds immediately after birth. These late preterm (34 weeks –36 weeks and 6 days) and early term (37 weeks–38 weeks and 6 days) infants are at increased risk for both breastfeeding cessation and complications of insufficient milk intake (e.g., dehydration, hypoglycemia, jaundice, and excessive weight loss). They are often expected to feed like term babies, but they have less strength and stamina to feed adequately. By convention, such children are often fed on expressed breast milk or other supplementary feeds through tubes, supplemental nursing systems , bottles, spoons or cups until they develop satisfactory ability to suck and swallow breast milk. Regardless of feeding method chosen, human milk feedings, whether from
20374-407: The infant via breast milk, such as alcohol , viruses ( HIV or HTLV-1 ), or medications. Even though most infants infected with HIV contract the disease from breastfeeding, most infants that are breastfed by their HIV positive mothers never contract the disease. While this paradoxical phenomenon suggests that the risk of HIV transmission between an HIV positive mother and her child via breastfeeding
20541-399: The infant's immune system. Produced during pregnancy and the first days after childbirth, colostrum is easy to digest and has laxative properties that help the infant to pass early stools. This aids in the excretion of excess bilirubin , which helps to prevent jaundice . Colostrum also helps to seal the infants gastrointestinal tract from foreign substances and germs, which may sensitize
20708-410: The infant's mouth should be asymmetric , meaning most of the "bottom" of the areola should be in the infants mouth and much more of the "top" of the areola should be visible. This position is helpful in pointing the nipple toward the roof of the infant's mouth, helping the infant recruit more milk. The baby's lips should be flanged out. The neck should be extended to facilitate swallowing, and as such,
20875-792: The infant's size and state of development rather than to the stage of pregnancy. About 213 million pregnancies occurred in 2012, of which, 190 million (89%) were in the developing world and 23 million (11%) were in the developed world. The number of pregnancies in women aged between 15 and 44 is 133 per 1,000 women. About 10% to 15% of recognized pregnancies end in miscarriage . In 2016, complications of pregnancy resulted in 230,600 maternal deaths , down from 377,000 deaths in 1990. Common causes include bleeding , infections , hypertensive diseases of pregnancy , obstructed labor , miscarriage, abortion, or ectopic pregnancy . Globally, 44% of pregnancies are unplanned . Over half (56%) of unplanned pregnancies are aborted. Among unintended pregnancies in
21042-654: The infant. The first type of milk produced is called colostrum . The volume of colostrum produced during each feeding is appropriate for the size of the newborn stomach and is sufficient, calorically, for feeding a newborn during the first few days of life. Produced during pregnancy and the first days after childbirth, colostrum is rich in protein and Vitamins A, B12 and K, which supports infants' growth, brain development, vision, immune systems, red blood cells, and clotting cascade. The breast milk also has long-chain polyunsaturated fatty acids which help with normal retinal and neural development. The caloric content of colostrum
21209-557: The infant; true low milk supply; severe nipple pain unrelieved by interventions; and medical contraindications to breastfeeding, as described below. Supplements can be delivered at the breast through a supplemental nursing system in order to stimulate the production of the mother's own milk and to preserve the breastfeeding relationship. Some parents may desire to supplement proactively if early signs of insufficient intake, such as decreased urination, dry mucous membranes, or persistent signs of hunger, are noticed. If these signs are noticed, it
21376-450: The latch process, the infant should be aligned with their abdomen facing their mother, which can be remembered as "tummy-to-mummy," and with their hips, shoulders and head aligned. This alignment helps to facilitate proper, efficient swallowing mechanics. Latching refers to how the baby fastens onto the breast while feeding. Sebaceous glands called Glands of Montgomery located in the areola secrete an oily fluid that lubricate and protect
21543-429: The likelihood of successful breastfeeding at discharge. Skin-to-skin mother-baby contact should still occur, even if the baby is born by Cesarean surgery. The baby is placed on the mother in the operating room or the recovery area. If the mother is unable to immediately hold the baby a family member can provide skin-to-skin care until the mother is able. According to studies cited by UNICEF , babies naturally follow
21710-401: The milk to come in over the next several days. The third stage of milk production occurs gradually over several weeks, and is characterized by a full milk supply that is regulated locally (at the breast), predominately by the infant's demand for food. This differs from the second stage of lactogenesis, which is regulated centrally (in the brain) by hormone feedback loops that naturally occur after
21877-401: The milk will be thicker and creamier. Human milk quenches the baby's thirst and hunger and provides the proteins, sugar, minerals, and antibodies that the baby needs. In the 1980s and 1990s, lactation professionals (De Cleats) used to make a differentiation between foremilk and hindmilk. But this differentiation causes confusion as there are not two types of milk. Instead, as a baby breastfeeds,
22044-1010: The milk's nitrogen, include urea , uric acid , creatine , creatinine , amino acids , and nucleotides . Breast milk has circadian variations; some of the nucleotides are more commonly produced during the night, others during the day. Mother's milk has been shown to supply endocannabinoids (the natural neurotransmitters that cannabis simulates) 2-arachidonoylglycerol , anandamide , oleoylethanolamide , palmitoylethanolamide , N-arachidonoyl glycine , eicosapentaenoyl ethanolamide, docosahexaenoyl ethanolamide, N-palmitoleoyl-ethanolamine, dihomo-γ-linolenoylethanolamine, N-stearoylethanolamine, prostaglandin F2alpha ethanolamides and prostaglandin F2 ethanolamides, Palmitic acid esters of hydroxy-stearic acids (PAHSAs). They may act as an appetite stimulant, but they also regulate appetite so infants do not eat too much. That may be why formula-fed babies have
22211-487: The mother and child wish. The World Health Organization's guidelines recommend "continue[d] frequent, on-demand breastfeeding until two years of age or beyond. Extended breastfeeding means breastfeeding after the age of 12 or 24 months, depending on the source. In Western countries such as the United States , Canada , and Great Britain , extended breastfeeding is relatively uncommon and can provoke criticism. In
22378-470: The mother during their first two hours after birth, the period that they tend to be more alert than in the following hours of early life. In the ideal childbirth , labor begins on its own when a woman is "at term". Events before completion of 37 weeks are considered preterm. Preterm birth is associated with a range of complications and should be avoided if possible. Sometimes if a woman's water breaks or she has contractions before 39 weeks, birth
22545-650: The mother is not herself deficient in vitamins, breast milk normally supplies her baby's needs, with the exception of Vitamin D. The CDC , National Health Service (UK), Canadian Paediatric Society , the American Academy of Pediatrics , and the American Academy of Family Physicians all agree that breast milk alone does not provide infants with an adequate amount of Vitamin D, thus they advise parents to supplement their infants with 400 IU Vitamin D daily. Providing this quantity of Vitamin D to breastfeeding infants has been shown to reduce rates of Vitamin D insufficiency (defined as 25-OH vitamin D < 50 nmol/L). However, there
22712-494: The mother or a donor, are important in the brain development of premature infants, and the NICU having a standardized protocol for feeding is protective against dangerous gastrointestinal infections ( necrotizing enterocolitis ) in these infants. Frequent breastfeeding and/or small amounts of supplementation may be needed for successful outcomes; breast pumping and/or hand expression is often helpful in providing adequate stimulation to
22879-415: The mother should focus on helping the infant by bringing their chin to the breast first. This facilitates a deep, asymmetric latch, and also helps the infant extend their neck and tilt their forehead back to maintain this deep latch and ease the swallowing process. In a good latch, a large amount of the areola, in addition to the nipple, is in the baby's mouth. The amount of areola visible on either side of
23046-520: The mother supports the baby's head with the opposite hand. The mother may choose a reclining position on her back or side with the baby lying next to her. No matter the position the parent-infant dyad finds most comfortable, there are a few components of every position which will help facilitate a successful latch . One key component is maternal comfort. The mother should be comfortable while breastfeeding, and should have her back, feet, and arms supported with pillows as necessary. Additionally, when starting
23213-457: The mother's breast within an hour of birth, globally, sixty percent of infants are not breastfed within this crucial first hour. Breastfeeding within the first hour of life protects the newborn from acquiring infections and reduces risk of death during the neonatal period. Alternatively, breast milk can be expressed using a breast pump and administered via baby bottle , cup, spoon, supplementation drip system, or nasogastric tube . This method
23380-740: The mother's breasts. Starting to breastfeed may be challenging for mothers of preterm infants, especially those born before 34 weeks, because their breasts may still be developing (in Lactogenesis I, see Breastfeeding Physiology). Additionally, mother–infant separation and the stressful environment of the NICU are also barriers to breastfeeding. Availability of a lactation specialist in the NICU can be helpful for mothers trying to establish their milk supply. Additionally, skin-to-skin (Kangaroo Care) has been shown to be safe and beneficial to both mother and baby. Kangaroo Care stabilizes newborn premature infants' vital signs, such as their heart rate, providing
23547-480: The mother, through her touching and taking care of the baby, comes into contact with pathogens that colonize the baby, and, as a consequence, her body makes the appropriate antibodies and immune cells. At around four months of age, the internal iron supplies of the infant, held in the hepatic cells of the liver, are exhausted. The American Academy of Pediatrics recommends that at this time that an iron supplement should be introduced. Other health organisations such as
23714-441: The muscular organ that holds the developing fetus, can expand up to 20 times its normal size during pregnancy. Head engagement , also called "lightening" or "dropping", occurs as the fetal head descends into a cephalic presentation . While it relieves pressure on the upper abdomen and gives a renewed ease in breathing, it also severely reduces bladder capacity, resulting in a need to void more frequently , and increases pressure on
23881-400: The nipple during latching. The visible portions of the glands can be seen on the skin's surface as small round bumps. The rooting reflex is the baby's natural tendency to turn towards the breast with the mouth open wide. When preparing to latch, mothers should make use of this reflex by gently stroking the baby's philtrum, the area between the upper lip and the nose, with their nipple to induce
24048-399: The nipple. La Leche League and Toronto Public Health offer several techniques to use during pregnancy or even in the early days following birth that may help to bring a flat or inverted nipple out. The World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of pacifiers for breastfeeding infants. In 2016 a large review of studies reported that the use of
24215-421: The nipples. This is called the let-down reflex. Some women report that they do not experience anything while others report a tingling feeling which is sometimes described as quite strong. The baby may be seen to respond to the beginning of the flow of milk by changing from quick sucks to deep rhythmic swallows. Sometimes the let-down is so strong that the baby splutters and coughs and the mother may need to remove
24382-527: The nursing infant. There is a commercial market for human breast milk, both in the form of a wet nurse service and as a milk product. As a product, breast milk is exchanged by human milk banks , as well as directly between milk donors and customers as mediated by websites on the internet. Human milk banks generally have standardized measures for screening donors and storing the milk, sometimes even offering pasteurization , while milk donors on websites vary in regard to these measures. A study in 2013 came to
24549-401: The nutritional benefits of breastmilk, breast milk also provides enzymes, antibodies, and other substances that support the infant's growth and development. The bioactive makeup of breastmilk also changes based on the needs of the infant; for example, when an infant is recovering from an upper respiratory infection , local signaling allows for increased passage of immune cells and proteins to aid
24716-416: The parent that infant weight gain is absolute proof of adequate milk intake. Thus, if the infant breastfeeding exclusively, and is gaining weight appropriately, then the parent can be reassured that they are producing enough milk. True low milk supply can be either primary (caused by medical conditions or anatomical issues in the mother), secondary (caused by not thoroughly and regularly removing milk from
24883-416: The pelvic floor and the rectum. It is not possible to predict when lightening will occur. In a first pregnancy it may happen a few weeks before the due date, though it may happen later or even not until labor begins, as is typical with subsequent pregnancies. It is during the third trimester that maternal activity and sleep positions may affect fetal development due to restricted blood flow . For instance,
25050-643: The period between the birth of the baby and the delivery of the placenta, which normally lasts less than 30 minutes. The delivery of the placenta causes an abrupt drop off of placental hormones. This drop, specifically in progesterone, allows prolactin to work effectively at its receptors in the breast, leading to an array of changes over the next several days that allow the milk to "come in"; these changes are known collectively as Lactogenesis II. Colostrum continues to be produced for these next few days, as Lactogenesis II occurs. Milk may "come in" as late as five days after delivery; however, this process may be delayed due to
25217-684: The physical changes. This condition is known as a false pregnancy . Most pregnant women experience a number of symptoms, which can signify pregnancy. A number of early medical signs are associated with pregnancy. These signs include: Pregnancy detection can be accomplished using one or more various pregnancy tests , which detect hormones generated by the newly formed placenta , serving as biomarkers of pregnancy. Blood and urine tests can detect pregnancy by 11 and 14 days, respectively, after fertilization. Blood pregnancy tests are more sensitive than urine tests (giving fewer false negatives). Home pregnancy tests are urine tests, and normally detect
25384-408: The placenta is delivered. Although traditionally, lactation occurs following pregnancy, lactation may also be induced with hormone therapy and nipple stimulation in the absence of pregnancy. Changes in pregnancy , starting around 16 weeks gestational age , prepare the breast for lactation. These changes, collectively known as Lactogenesis I , are directed by hormones produced by the placenta and
25551-697: The production of breast milk. These medications may be beneficial in cases where women with hypothyroidism may be unable to produce milk. A Cochrane review looked at the drug domperidone (10 mg three times per day) with results showing a significant increase in volume of milk produced over a period of one to two weeks. However, another review concluded little evidence that use of domperidone and metoclopramide to enhance milk supply works. Instead, non-pharmacological approaches such as support and more frequent breastfeeding may be more efficacious. Finally, there are other substances besides medications that may appear in breast milk. Alcohol use during pregnancy carries
25718-432: The production of oxytocin (see Production). Breastfeeding can also reduce the risk of breast cancer later in life. Lactation may also reduce the risk for both mother and infant from both types of diabetes. Lactation may protect the infant from specifically developing Type 2 diabetes, as studies have shown that bioactive ingredients in human breast milk could prevent excess weight gain during childhood via contributing to
25885-565: The release of oxytocin , a hormone also released during breastfeeding . Studies show that skin-to-skin contact between a mother and her newborn immediately after birth is beneficial for both the mother and baby. A review done by the World Health Organization found that skin-to-skin contact between mothers and babies after birth reduces crying, improves mother–infant interaction, and helps mothers to breastfeed successfully. They recommend that neonates be allowed to bond with
26052-451: The risk of breast , ovarian , and endometrial cancer , and the risk declines further with each additional full-term pregnancy. The fetus is genetically different from its mother and can therefore be viewed as an unusually successful allograft . The main reason for this success is increased immune tolerance during pregnancy, which prevents the mother's body from mounting an immune system response against certain triggers. During
26219-520: The risk of obesity in adulthood. Benefits for the mother include less blood loss following delivery , better contraction of the uterus, and a decreased risk of postpartum depression . Breastfeeding delays the return of menstruation , and in very specific circumstances, fertility , a phenomenon known as lactational amenorrhea . Long-term benefits for the mother include decreased risk of breast cancer , cardiovascular disease , diabetes , metabolic syndrome , and rheumatoid arthritis . Breastfeeding
26386-478: The risk of gastrointestinal allergies to food, respiratory allergies to air particles like pollen, and other atopic diseases , such as asthma and eczema . It is recommended for mothers to initiate breastfeeding within the first hour after birth. Uninterrupted skin-to-skin contact and breastfeeding can begin immediately after birth, and should continue for at least one hour after birth. This period of infant-mother interaction, known generally as kangaroo care , or
26553-409: The sole source of nutrition for exclusively breastfed newborns, supplying all necessary nutrients for infants up to six months. Beyond this age, breast milk continues to be a source of energy for children up to two years old, providing over half of a child's energy needs up to the age of one and a third of the needs between one and two years of age. Despite the capability of most newborns to latch onto
26720-491: The start of breastfeeding but disappear or become considerately more manageable after the first few weeks. Feedings may last as long as 30–60 minutes each as milk supply develops and the infant learns the Suck-Swallow-Breathe pattern. However, as milk supply increases and the infant becomes more efficient at feeding, the duration of feeds may shorten. Older children may feed less often. When direct breastfeeding
26887-402: The start of the last menstrual period (LMP), a span known as the gestational age . This is just over nine months. Counting by fertilization age , the length is about 38 weeks. Pregnancy is "the presence of an implanted human embryo or fetus in the uterus"; implantation occurs on average 8–9 days after fertilization. An embryo is the term for the developing offspring during
27054-491: The start of the last menstrual period ) The chronology of pregnancy is, unless otherwise specified, generally given as gestational age , where the starting point is the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. This model means that the woman is counted as being "pregnant" two weeks before conception and three weeks before implantation . Sometimes, timing may also use
27221-507: The success of the new flavour, the Westminster Council officers removed the product from the menu to make sure that it was, as they said, "fit for human consumption." Tammy Frissell-Deppe, a family counsellor specialized in attachment parenting , published a book, titled A Breastfeeding Mother's Secret Recipes , providing a lengthy compilation of detailed food and beverage recipes containing human breast milk. Human breast milk
27388-515: The tissue surrounding and supporting the milk-producing cells and ducts. Engorgement most frequently occurs as milk "comes in" and during the weaning process. As milk is coming in, several processes occur. At the end of pregnancy there is dilation of the blood vessels which supply the breast, allowing for leaking into the tissue or interstitial space . Additionally, the birth of an infant is followed by massive fluid shifts to both offload excess fluid, which had been used to supply oxygen and nutrients to
27555-415: The volume of milk she will produce. The process of milk production, termed lactogenesis , occurs in 3 stages. The first stage takes place during pregnancy, allowing for the development of the breast and production of colostrum, the thick, early form of milk that is low in volume, but rich in nutrition. The birth of the baby and the placenta triggers the onset of the second stage of milk production, triggering
27722-447: The woman herself, or by using pregnancy tests . However, an important condition with serious health implications that is quite common is the denial of pregnancy by the pregnant woman. About 1 in 475 denials will last until around the 20th week of pregnancy. The proportion of cases of denial, persisting until delivery is about 1 in 2500. Conversely, some non-pregnant women have a very strong belief that they are pregnant along with some of
27889-552: Was insufficient evidence in the most recent Cochrane Review , to determine if this quantity reduced rates of Vitamin D deficiency (defined as 25-OH vitamin D < 30 nmol/L) or rickets . Term infants typically do not need iron supplementation. Delaying clamping of the cord at birth for at least one minute improves the infants' iron status for the first year. When complementary (solid) foods are introduced at about 6 months of age, parents should make sure to choose iron-rich foods to help maintain their children's iron stores. In addition to
#388611